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Simple Summary: Screening for breast, colorectal, and cervical cancer is correlated with diagnosis at an earlier stage, less extensive surgery, and reduced mortality and fewer complications. Adherence rates to cancer screening are lower for individuals with low socio-economic conditions and educational attainment. These social disparities are only partially reduced by free screening through national initiatives. Education and information and appropriate expenditure for preventive care have the potentials to increase adherence to screening for colorectal, breast, and cervical cancer with the possibility of reduced cancer mortality. The findings of our study highlight the importance of the implementation of nationally organized screening programs for several other types of cancers that are often detected after the occurrence of symptoms. Nationally organized screening programs for several types of cancers, like esophageal, gastric, and pancreatic cancer, in regions with a high prevalence may increase the possibility of diagnosis at earlier stages and improved early and late results. The objective of this study was to determine the correlation between adherence to cancer screening programs and earlier diagnosis of the 14 most common types of cancers in the adult population, before and during the COVID-19 pandemic. National data concerning number of admissions and operations in Italy for adult patients admitted with oncologic problems during the COVID-19 pandemic (2020 to 2022) and in the pre-pandemic period (2015 to 2019) were analyzed. We selected 14 types of cancer that present the most common indications for surgery in Italy. This study included 1,365,000 adult patients who had surgery for the 14 most common types of cancer in the period 2015–2022, and interviews concerning adherence rates to screening for breast, colorectal, and cervical cancer were conducted for 133,455 individuals. A higher decrease in the number of operations for the 14 types of cancer (−45%) was registered during the first three acute phases of the pandemic, and it was more evident for screenable cancers like breast, colorectal, and cervical cancer (p < 0.001). During the first year of the COVID-19 pandemic, the number of screened individuals for breast, colorectal, and cervical cancer decreased by 33.8% (from 7,507,893 to 4,969,000) and the number of diagnoses and operations for these three types of cancer decreased by 10.5% (from 107,656 to 96,405). The increase and return to normality of the number of screened individuals in the last year of the pandemic (2022) and in the first post-pandemic year (2023) was associated with a return to the pre-pandemic levels of diagnoses and operations. The adherence rates were lower for individuals living in rural areas, with low socio-economic status, and unmarried persons; however, the most statistically significant factor for reduced adherence was a lower level of educational attainment. Free screening through nationally organized programs reduced social disparities. There were no significant differences between the pre-pandemic and pandemic periods for several types of cancers (stomach, esophagus, pancreas, liver) that are diagnosed for the occurrence of symptoms and for which nationally organized programs might increase the possibility of earlier diagnosis and improved clinical outcomes. Education, information, and appropriate expenditure for preventive care have the potential to reduce cancer mortality. Nationally organized screening programs for several types of cancers, which are often detected for the occurrence of symptoms, may increase the possibility of diagnosis at earlier stages. [ABSTRACT FROM AUTHOR]

Simple Summary: In recent years, liquid biopsy has been introduced as a new method for the detection and management of cancer, but the studies on oral squamous cell carcinoma (OSCC) are lacking conclusive evidence. The aim of this study was to evaluate the expression of six circulating salivary and plasmatic miRNAs (-21, -31, -138, -145, -184, and -424) as diagnostic biomarkers in patients affected by OSCC and by oral potentially malignant disorders (OPMDs). Our results showed that liquid biopsy from saliva may be a useful tool for the identification of these biomarkers; in particular, miR-138 and miR-424 showed decreased expression levels in saliva samples in OSCC and OPMD patients compared to healthy controls. The introduction of liquid biopsy in daily clinical practice could revolutionize the approach to oral lesions by allowing the mass screening, stratification and monitoring of patients at risk, the monitoring of the response to treatment and the early identification of any recurrences. This study aims to evaluate the expression of salivary and plasmatic miRNAs as diagnostic biomarkers in patients with oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs). A total of 25 patients were divided into three groups, according to their diagnosis: OSCC patients (n = 14); OPMDs patients (n = 6); and healthy controls (n = 5). At the time at diagnosis/enrolment, patients underwent salivary and plasmatic collection. The expression of miRNA -21, -31, -138, -145, -184, and -424 were evaluated by real-time PCR. An F-test and ANOVA test were performed to evaluate the miRNA levels (significance at p < 0.05). By comparing miRNA expression levels from saliva, a statistically significant difference emerged in the expression of miR-138 and miR-424 between the three groups (p < 0.05). In particular, these two miRNAs showed decreased expression levels in saliva samples from OSCC and OPMD patients compared to those from healthy controls. On the other hand, miRNA expression levels in plasma were low in all the groups, and no statistically significant differences were found. Overall, our results showed that liquid biopsy from saliva may be a useful tool for the identification of diagnostic molecular biomarkers in OSCC and OPMDs. [ABSTRACT FROM AUTHOR]

Simple Summary: Total thyroidectomy and dissection of cervical lymph node compartments, depending on serum calcitonin levels and ultrasound findings, is standard treatment for patients with medullary thyroid cancer. The aim of this study was to evaluate whether pre-operative calcitonin and CEA levels can be useful as biomarkers of the extent of lymph node metastases at diagnosis. Results indicate that pre-operative serum calcitonin and CEA levels can predict presence, number, and site of lymph node metastases and, more specifically, values of 90 pg/mL for calcitonin and 17 ng/mL for CEA accurately indicate the N1b status. Since surgery is the only curative treatment for medullary thyroid cancer and there is not a strong indication regarding the extent of lymphadenectomy, these findings may help in the choice of the extent of neck dissection. Background: In medullary thyroid cancer (MTC), lymph node metastases are often present at diagnosis and the extent of surgery is usually based upon pre-operative calcitonin and CEA levels as well as ultrasound findings. The aim of this study was to evaluate the role of pre-operative calcitonin and CEA levels as predictive markers of the burden of lymph node metastases at diagnosis. Methods: we conducted a retrospective study analyzing 87 MTC patients. Results: The median levels of calcitonin and CEA were 88.4 pg/mL and 7.0 ng/mL, respectively, in patients with no lymph nodes metastases; 108.0 pg/mL and 9.6 ng/mL, respectively, in patients with metastases to 1–5 lymph nodes; 520.5 pg/mL and 43.2 ng/mL, respectively, in patients with metastases to >5 lymph nodes. There were no significant differences in pre-operative calcitonin and CEA values between N0 and N1a patients, whereas they were significantly higher in N1b patients. Pre-operative cut-off levels distinguishing N0/N1a from N1b patients were 90 pg/mL for calcitonin (sensitivity 100%, specificity 59.3%, AUC = 0.82) and 17 ng/mL for CEA (sensitivity 100%, specificity 75%, AUC = 0.89). Conclusions: in patients with MTC, pre-operative serum calcitonin and CEA levels may drive the decision-making process to better define the extent of surgery. [ABSTRACT FROM AUTHOR]

Simple Summary: Adjuvant therapy with targeted therapy or immunotherapy has become the standard of care for fully resected stage III–IV melanoma. In this scenario, real-world data are needed to relate the actual effectiveness and safety of these regimens with the evidence provided in the clinical trials. This study provides clinicians and researchers with the results of an Italian single-center real-world experience on the use of adjuvant therapy in resected stage III–IV melanoma patients. Our findings confirm the real-world effectiveness and safety of adjuvant regimens, yet underscores the need for further research to explore biomarker-based predictors for relapse and to assess the translation of improved relapse-free survival into long-term overall survival benefit. This study was carried out at the Dermatologic Clinic of the University of Turin, Italy, to assess the effectiveness and safety of adjuvant therapy in patients who received either targeted therapy (TT: dabrafenib + trametinib) or immunotherapy (IT: nivolumab or pembrolizumab) for up to 12 months. A total of 163 patients participated, including 147 with stage III and 19 with stage IV with no evidence of disease. The primary outcomes were relapse-free survival (RFS), distant metastasis-free survival (DMFS), and overall survival (OS). At 48 months, both TT and IT approaches yielded comparable outcomes in terms of RFS (55.6–55.4%, p = 0.532), DMFS (58.2–59.8%, p = 0.761), and OS (62.4–69.5%, p = 0.889). Whilst temporary therapy suspension was more common among TT-treated patients compared to IT-treated individuals, therapy discontinuation due to adverse events occurred at comparable rates in both groups. Predictors of relapse included mitoses, lymphovascular invasion, ulceration, and positive sentinel lymph nodes. Overall, the proportion of BRAF-mutated patients receiving IT stood at 7.4%, lower than what was observed in clinical trials. [ABSTRACT FROM AUTHOR]

Simple Summary: This pilot study aims to identify the physical, mental, social, psychological, and health needs encountered by cancer survivors in order to propose and facilitate appropriate and tailored responses. To the best of our knowledge, this is one of the first multidimensional studies investigating this topic in Italy. Data show that the quality of life of cancer survivors is affected by cancer and its treatment, reporting more frailties than the general population, especially those over 65 years old. These findings could help develop multidisciplinary planning of survivorship care for the transition of patients from oncological management to primary healthcare. Background: Understanding the specific needs of cancer survivors is essential for healthcare policy. In Italy, dedicated studies are lacking, so we aimed to investigate the physical, mental, social, and health difficulties encountered by these patients. Methods: We conducted a cross-sectional study on breast or colorectal cancer survivors (people 5+ years free from it and its treatments) using an ad hoc survey including validated questionnaires (Grauer–Palombi, SF-36, PREDIMED). Participants were recruited within the Oncology Unit of the "Policlinico Tor Vergata", Italy. Results: A total of 62 patients (80.6% females; years range: 37–87) agreed to be interviewed. A profile of cancer survivors was drafted: an overaged person with multiple co-morbidities, not well-nourished, adhering to the Mediterranean diet, reporting critical conditions as for physical and functional status. The mean number of co-morbidities was 3.6 ± 2.4 SD, with a statistically significant difference between age groups (under and over 65). Compared to the general population, the sample showed more frailties, especially when >65. The risk of having multimorbidity (four or more co-morbidities) significantly increased in those over 65 (OR: 4.72; CI: 1.43–15.59). Conclusion: There is an urgent need for survivorship care planning for the patient-centered continuum of care. Assessing and monitoring their specific needs will help propose appropriate and tailored responses. [ABSTRACT FROM AUTHOR]

Climate change threatens environmental stability and human health, with limited research on younger children's perceptions. This study examines Italian primary school children's views on climate change to guide educational and policy strategies. Surveying 973 children (5–11 years) from different regions, findings showed high awareness (93%) and concern (63%) about climate change. Regional differences indicated greater concern in the south. Gender disparities revealed females were more concerned and experienced more sleep difficulties. Younger children had stronger emotional responses, while older ones showed increased pro-environmental behaviors. Despite moderate self-confidence in effecting change, a strong sense of responsibility and trust in adults was prevalent. These results highlight the need for early, continuous climate education tailored to regional, age, and gender-specific needs. Addressing children's views on climate change can help educators and policymakers foster resilience and proactive attitudes, supporting the development of informed and engaged future stewards of the planet. [ABSTRACT FROM AUTHOR]

Background: Healthcare professionals frequently encounter various forms of aggression, ranging from verbal abuse to physical assaults, which can compromise both their occupational well-being and patient-care quality. Despite its prevalence and serious consequences, workplace aggression is often underreported due to a lack of standardized assessment tools. This study aims to develop a valid Italian version of the Hospital Aggressive Behaviour Scale-Users. Methods: The scale's structure was evaluated using exploratory (EFA) and confirmatory (CFA) factor analyses on two samples of healthcare professionals during and after the pandemic. Reliability, measurement invariance, and nomological validity were examined. Results: EFA revealed a two-factor structure comprising eight items (χ2 = 59.651, df = 13, p = 0.00; CFI = 0.98; TLI = 0.95; RMSEA = 0.07; SRMR = 0.02), distinguishing non-physical and physical aggression, and meeting all recommended criteria. CFA confirmed this structure, demonstrating good reliability and outperforming alternative models. The same factor structure was confirmed in standard (χ2 = 35.01, df = 19, p = 0.00; CFI = 0.99; TLI = 0.99; RMSEA = 0.03; SRMR = 0.02) and emergency (χ2 = 30.65, df = 19, p = 0.04; CFI = 0.98; TLI = 0.97; RMSEA = 0.06; SRMR = 0.04) contexts. Full residual invariance was found across job tenure groups. Aggression was positively associated with emotional exhaustion, psychological distance, psychosomatic symptoms, post-traumatic stress symptoms, and turnover intentions while negatively related to job satisfaction. Nurses and healthcare assistants reported higher levels of aggression than doctors. Conclusions: This study provides a reliable, context-specific instrument for documenting and analysing outsider aggression. The insights can inform targeted interventions, contributing to a healthier hospital environment. [ABSTRACT FROM AUTHOR]

Background: In May 2023, Romagna, Italy, faced a devastating flood resulting in 16 fatalities, forced displacement of 26,000 citizens, and significant economic losses. Due to potential water contamination, implementing public health strategies became imperative for the Local Health Authority to mitigate the health consequences, analyze the flood's impact on the local population's health, and detect early anomalies requiring timely public health interventions. Methods: Between June and July 2023, general practitioners who were part of the RespiVirNet surveillance network completed weekly structured forms. These forms collected data on individuals exposed or not to floodwaters and clinical syndromes. Rates per 1000 resident population aged > 14 were stratified by district, week of observation, and symptomatology. Missing data were addressed by imputation using second-order autoregressive modeling. Results: An incidence of 3.52 syndromes potentially related to flood water exposure per 1000 individuals (95% CI 2.82–4.35) was estimated. Ravenna, the city most affected by the flood, recorded the highest rate (6.05 per 1000, 95% CI 4.59–7.82). Incidence decreased in the weeks post-event. Anxiety, or trauma and stress symptoms, exhibited higher rates among the exposed, diminishing over weeks. The incidence for the non-exposed (12.76 per 1000, 95% CI 10.55–15.29) showed no significant territorial differences compared to the exposed ones. Conclusions: Syndromic surveillance provided timely information on the flood's health impact, revealing a higher incidence of individual syndromes among the non-exposed. This study contributes to guiding the implementation of future public health preparedness and response strategies for populations facing similar natural disasters. [ABSTRACT FROM AUTHOR]

The HAGOS (Hip and Groin Outcome Score) questionnaire is a valid and reliable measure of the self-assessment of symptoms, activity limitation, participation restriction, and quality of life (Qol) of subjects with hip and/or groin pain. The aims of this study are to translate and transculturally adapt the HAGOS into Italian (HAGOS-I) and to assess its internal consistency, validity, and reliability in physically active, young, and middle-aged subjects. The translation and transcultural adaptation of (HAGOS-I) was carried out according to international guidelines. Eight-one subjects (mean age 28.19) were included in this study. All the participants completed the HAGOS-I, the Lower Extremity Functional Scale (LEFS-I), the Oxford Hip Score (OHS-I), and the Short Form 36 Health Surveys (SF-36-I). The Cronbach's α for the six HAGOS subscales ranged from 0.63 to 0.87. Statistically significant correlations were obtained between the six HAGOS-I subscales and the LEFS-I (rs = 0.44–0.68; p < 0.01). Only one HAGOS-I subscale (Participation in Physical Activities) did not reach statistical significance with the OHS-I, while the remaining five had a moderate correlation (rs = 0.40–0.60; p < 0.01). The test–retest reliability (Intraclass Correlation Coefficient) ranged from 0.57 to 0.86 for the six HAGOS-I subscales. The HAGOS-I is a valid and reliable instrument that can be used in clinical settings with young and middle-aged subjects with hip and/or groin pathologies. [ABSTRACT FROM AUTHOR]

Emotions are dynamic processes; their variability relates to psychological well-being and psychopathology. Affective alterations have been linked to mental diseases like depression, although little is known about how similar patterns occur in healthy individuals. This study investigates the psychophysiological correlations of emotional processing in healthy subjects, specifically exploring the relationship between depressive traits, cognitive distortions, and facial electromyographic (f-EMG) responses during affective transitions. A cohort of 44 healthy participants underwent f-EMG recording while viewing emotional images from the International Affective Picture System (IAPS). Self-report measures included the Beck Depression Inventory (BDI) and the Cognitive Distortion Scale (CDS). Higher BDI scores were associated with increased EMG activity in the corrugator muscle during transitions between positive and negative emotional states. Cognitive distortions such as Catastrophizing, All-or-Nothing Thinking, and Minimization showed significant positive correlations with EMG activity, indicating that individuals with higher levels of these distortions experienced greater facial muscle activation during emotional transitions. This study's results indicate that there is a bidirectional correlation between depressed features and cognitive distortions and alterations in facial emotional processing, even in healthy subjects. Facial EMG in the context of dynamic affective transitions has the potential to be used as a non-invasive method for detecting abnormal emotional reactions at an early stage. This might help in identifying individuals who are at risk of developing depression and guide therapies to prevent its advancement. [ABSTRACT FROM AUTHOR]

Simple Summary: Pancreatic cancer is one of the deadliest cancers due to its subtle onset and advanced stage at diagnosis. With most patients having inoperable cancer at diagnosis, survival rates remain low despite existing treatments. Our review aims to map and summarize current studies on FGFR inhibitors, a promising new treatment targeting specific cancer pathways. We found that while there are many preclinical studies, clinical research is still emerging, focusing mainly on the efficacy and safety of these treatments. Although FGFR alterations are relatively rare in pancreatic cancer, the few available real-life data are promising. Future research should aim to better identify the genetic drivers of this cancer and gather more data on long-term outcomes. This could lead to improved treatments and better survival rates for patients with pancreatic cancer. Pancreatic cancer is a highly lethal disease, often diagnosed at advanced stages, with a 5-year overall survival rate of around 10%. Current treatments have limited effectiveness, underscoring the need for new therapeutic options. This scoping review aims to identify and summarize preclinical and clinical studies on FGFR (Fibroblast Growth Factor Receptor) inhibitors, including tyrosine kinase inhibitors (TKIs) and FGFR-specific inhibitors, in pancreatic cancer with FGFR alterations. We included studies analyzing efficacy, safety, and survival outcomes in various populations. A comprehensive search across major databases identified 73 relevant studies: 32 preclinical, 16 clinical, and 25 from gray literature. The clinical trials focused primarily on efficacy (20 studies) and safety (14 studies), with fewer studies addressing survival outcomes. FGFR1 was the most studied alteration, followed by FGFR2 and FGFR4. Although FGFR alterations are relatively rare in pancreatic cancer, the available data, including promising real-life outcomes, suggest significant potential for FGFR inhibitors. However, more extensive research is needed to identify the correct genetic drivers and gather robust survival data. Ongoing and future trials are expected to provide more comprehensive insights, potentially leading to improved targeted therapies for pancreatic cancer patients with FGFR alterations. [ABSTRACT FROM AUTHOR]

Simple Summary: Postoperative hypoparathyroidism (HypoPTH) is the most common complication following total thyroidectomy, but the literature still lacks clear risk and protective factors. This study aimed to evaluate and compare the risk factors for post-surgical HypoPTH in a large series of patients at a tertiary academic high-volume center undergoing total thyroidectomy for both benign and malignant diseases. It also focused on identifying risk and protective factors for persistent HypoPTH. Background: Postoperative hypoparathyroidism (HypoPTH) is the most common complication following total thyroidectomy. Several risk factors have been identified, but data on postoperative follow-up are scarce. Methods: The study focused on 1965 patients undergoing surgery for benign and malignant thyroid diseases at a tertiary-level academic center. Anamnestic, biochemical, surgical, pathological, and follow-up data were evaluated. HypoPTH was defined by a serum concentration of PTH < 10 pg/mL on the first or the second post-operative day. Persistent HypoPTH was defined by the need for calcium/active vitamin D treatment > 12 months after surgery. Results: Postoperative HypoPTH occurred in 542 patients. Multivariate analysis identified the association of central lymph-nodal dissection, reduced preoperative PTH levels, a lower rate of parathyroid glands preserved in situ, and longer duration of surgery as independent risk factors. At a median follow-up of 47 months, HypoPTH regressed in 443 patients (more than 6 months after surgery in 7%) and persisted in 53 patients. Patients receiving a lower dose of calcium/active vitamin D treatment at discharge (HR 0.559; p < 0.001) or undergoing prolonged, tailored, and direct follow-up by the operating endocrine surgeon team had a significantly lower risk of persistent HypoPTH (2.4% compared to 32.8% for other specialists) (HR 2.563; p < 0.001). Conclusions: Various patient, disease, and surgeon-related risk factors may predict postoperative HypoPTH. Lower postoperative calcium/active vitamin D treatment and prolonged, tailored follow-up directly performed by operating endocrine surgeons may significantly reduce the rate of persistent HypoPTH. [ABSTRACT FROM AUTHOR]

Simple Summary: An ultrasound-guided percutaneous lung biopsy performed by a pulmonologist is a safe, minimally invasive procedure for patients with suspected lung malignancies, providing an excellent diagnostic yield for a comprehensive molecular profiling and programmed death ligand 1 testing. Moreover, ultrasound-guided percutaneous lung biopsy may represent a successful approach for diagnosis of lung lymphoid lesions, with potential implication on reducing time-to-treatment time. Background: The recent advances in precision oncology for lung cancer treatment has focused attention on the importance of obtaining appropriate specimens for tissue diagnosis as well as comprehensive molecular profiling. CT scan-guided biopsies and bronchoscopy are currently the main procedures employed for tissue sampling. However, growing evidence suggests that ultrasound-guided biopsies may represent an effective as well as safe approach in this diagnostic area. This study explores the safety and the diagnostic yield for cancer molecular profiling in ultrasound-guided percutaneous lung lesion biopsies (US-PLLB). Methods: One hundred consecutive patients with suspected lung cancer, between January 2021 and May 2024, who had ultrasound-guided lung biopsies have been retrospectively analyzed. Molecular profiling was conducted with next-generation sequencing Genexus using Oncomine precision assay or polymerase chain reaction according to specimen quality. Qualitative immunohistochemical assay of programmed death ligand 1 (PD-L1) expression was evaluated by the Dako PD-L1 immunohistochemistry 22C3 pharmDx assay. The co-primary endpoints were the molecular diagnostic yield and the safety profile of US-guided lung biopsies. Results: From January 2021 to May 2024, 100 US-guided lung biopsies were carried out and 95 were considered for inclusion in the study. US-PLLB provided informative tissue for a histological evaluation in 93 of 95 patients with an overall diagnostic accuracy of 96.84% [Sensitivity: 92.63%; Specificity: 96.84%; PPV: 100%; NPV: 100%]. Sixty-Six patients were diagnosed with NSCLC (69.47%) and were considered for molecular diagnostic yield evaluation and PD-L1 testing. Four patients had malignant lymphoid lesions. US-PLLB was not adequate to achieve a final diagnosis in three patients (3.16%). Complete molecular profiling and PD-L1 evaluation were achieved in all patients with adenocarcinoma (molecular diagnostic yield: 100%). PD-L1 evaluation was achieved in 28 of 29 patients (96.55%) with either SCC or NOS lung cancer. The overall complication rate was 9.47% (n = 9). Six patients (6.31%) developed pneumothorax, while three patients (3.16%) suffered mild haemoptysis without desaturation. Conclusions: According to our findings, US-guided lung biopsy is a safe, minimally invasive procedure in patients with suspected lung malignancies, providing an excellent diagnostic yield for both comprehensive molecular profiling and PD-L1 testing. In addition, our results suggest that US-guided biopsy may also be an effective diagnostic approach in patients with suspected lung lymphoma. [ABSTRACT FROM AUTHOR]

Background: Even if robotic assisted total knee arthroplasty (RATKA) is a widely used technique, there is still a gap of knowledge about whether this technology is effective in improving the patient utility. This measure is of paramount importance for conducting cost effectiveness analysis. The aim of this study was to compare the utility measure derived from self-reported outcomes questionnaires in patients who underwent RATKA compared to patients who underwent the manual surgery. Methods: We compared 72 patients operated with a robotic technique with 70 operated with traditional technique. The utility data were collected with the WOMAC (Western Ontario and McMaster University Osteoarthritis index) self-administrated questionnaire that investigates pain, stiffness and functionality of the patients, an then mapped to a utility value through a validated transforming function. We performed three surveys: the first one before the intervention (t0), the second one 1 year after the surgery (t1) and the third one at the 2 year follow up (t2). Results: we observed higher utility values in both groups. In detail, the mean utility score in the RATKA group increased from 0.37 to 0.71 (t1) and 0.78 (t2), while in the conventional group it increased from 0.41 to 0.78 (t1) and 0.78 (t2). The fixed effect coefficients of t1 and t2 were found to be 0.37 and 0.363 (p < 0.001 for both). The coefficient of the robotic technique, along with its interaction with the t1 and t2 time effect was non-significant. Conclusions: Even if at t1 the utility of patient who underwent RATKA were lower, at longer follow up (t2) we found no significant difference compared to traditional technique, leaving the superiority of robotic assisted technique yet to be proved. Our results may be useful for calculating the gained or lost Quality Adjusted Life Years (QALYs), so that the health care system (or an insurance company) could make an appropriate decision whether to fund the robotic approach or not, after a careful assessment of the incremental costs incurred. [ABSTRACT FROM AUTHOR]

Most researchers have assessed cognitive functions in post-COVID-19 patients by means of screening tools and found cognitive sequelae in addition to anxiety, stress, depression, and a reduced quality of life (QoL). This study was aimed at investigating cognitive and psychological sequelae in patients admitted to the intensive care unit (ICU) six months (t6) and one year (t12) after discharge from the hospital, the impact of critical illness on well-being and QoL, and the protective role of cognitive reserve (CR). Twenty-three ICU patients underwent an extensive neuropsychological test battery at t6 and t12; a healthy control group underwent the same evaluation. Patient scores were compared with control scores: patients reported significantly lower scores in visual–spatial functions, both at t6 (U = 122; p = 0.033) and at t12 (U = 70; p = 0.003), and higher levels of anxiety (U = 126; p = 0.043) and depression (U = 97; p = 0.005) at t6; the levels of anxiety decreased at t12, while only depression symptoms persisted (U = 99.5; p = 0.025). Regarding the QoL, patients obtained lower scores in the physical component of QoL, both at t6 (U = 72; p = 0.008) and at t12 (U = 56.5; p = 0.005). Few and moderate correlations emerged between isolated cognitive functions and CR and the length of hospital stay. The results suggest a prevalent visual–spatial involvement, the medium- and long-term persistence of psychological sequelae, and a reduced QoL in ICU patients. [ABSTRACT FROM AUTHOR]

(1) Background: Physical activity is known to promote health and psychological well-being in older adults, yet global inactivity rates in this population remain high. Among the factors associated with physical activity, self-efficacy for exercise represents a key predictor for developing effective interventions in older adults. This study aimed to validate the Self-Efficacy for Exercise Scale (SEE) in individuals over 65. (2) Methods: A sample of 726 older adults from the USA and Italy (51.1% females; age range = 65–95 years; Mage = 72.57, SDage = 6.49) completed the SEE, along with the Godin–Shepard Leisure-Time Physical Activity Questionnaire (GSLTPAQ), the Big Five Inventory 2—Extra Short Form (BFI-2-XS), and the 12-item Short Form Health Survey (SF-12). (3) Results: The SEE showed a Cronbach's Alpha of 0.88 and a Composite Reliability of 0.89. Moreover, it demonstrated a unidimensional factor structure and good fit indices. Full measurement invariance was achieved across gender and age, while partial scalar invariance was found across countries, suggesting minor cultural differences. Correlation with the GSLTPAQ, the BFI-2-XS, and the SF-12 support the convergent and nomological validity of the SEE. (4) Conclusions: These findings provide evidence that the SEE is a reliable and valid measure of self-efficacy for exercise among older adults and that the items are interpreted similarly across different ages, genders, and cultures. [ABSTRACT FROM AUTHOR]

Whereas an exercise intervention effectively improves patients' quality of life, little information is available about the contribution of each physical fitness component. This study aims to explore the association between physical fitness components and the quality-of-life domain in patients with cancer. Between September 2021 and August 2023, 160 patients with mixed cancer types visiting the Oncology Unit were selected on a consecutive basis according to selection criteria. They underwent a comprehensive baseline assessment including the six-minute walking test, the handgrip strength test, the isometric leg press test, the back scratch, sit and reach tests, their waist–hip ratio, and their body mass index. The European Organization for Research and Treatment of Cancer Quality of Life and Core Questionnaire was used to measure the quality of life. The sample size was based on the use of regression models to study associations between clinical characteristics and fitness outcomes. All of the analyses were performed using the SPSS v.25 statistical package. Patients had a mean age of 58 years, 68% were female, 42% were affected by breast cancer, and all were receiving anticancer treatments. Higher functional capacity was associated with better global health status (p < 0.0001) and physical (p < 0.0001), role (p < 0.0001), emotional (p = 0.026), and social function (p = 0.016) and inversely linked with fatigue (p = 0.001). Lower-limb flexibility was significantly associated with all of the domains except for role and social functions. The waist–hip ratio was inversely associated with physical function (p < 0.0001) and positively related to fatigue (p = 0.037). Exercise programs aiming to improve the quality of life in cancer should be addressed to optimize these fitness components. [ABSTRACT FROM AUTHOR]

Introduction: Since the COVID-19 pandemic, the Italian National Health Service (NHS) has been undergoing a structural reform shifting focus from hospital-centered care to smaller, intermediate, or primary health facilities closer to the community (e.g., community hospitals and community houses). This reorganization should include rehabilitation and physiotherapy, but the actual spread of these services is still unclear. Objective: This study explored the number and characteristics of community-based physiotherapy services in the Metropolitan City of Milan (Italy). Methods: Between April and May 2024, we distributed a structured, anonymous online survey about community physiotherapy services and users to all Directors of the Health and Social Care Professions Departments (DAPSS) in the Metropolitan City of Milan. We used descriptive statistics to analyze the number of community houses offering physiotherapy services, the specific intervention areas, and access modalities. Results: Six out of seven DAPSS Directors completed the survey (87%). Thirty-seven community houses were reported in the area, with fourteen of these offering physiotherapy services. In most of them, physiotherapy was a primary reason for access following a general practitioner's prescription. Five out of six responders reported that rehabilitation needs were mainly assessed by specialists in Physical and Rehabilitation Medicine, with physiotherapists involved in the assessment process in two cases. Physiotherapists primarily handled the intervention phase, dealing mainly with orthopedic and neurological conditions. DAPSS Directors noted that additional physiotherapy initiatives focusing on prevention will be implemented. Conclusions: Physiotherapy services are becoming available in the Metropolitan City of Milan. However, more efforts are needed to facilitate access and ensure tailored assessment and effective interventions, particularly in preventive care. Future investigations should help to better define the number and the characteristics of the patients who can most benefit from this type of care, the number of sessions they need, and with what types of intervention; it would be also necessary to better define the communication network in the area that allows doctors, health professionals, and patients to be informed about this possibility. [ABSTRACT FROM AUTHOR]

In patients with spinal cord injury (SCI), patient-reported outcomes (PROMs) and experience of care measures (PREMs) are extremely relevant for the prognosis. However, there is a paucity of research on these topics. We conducted a cross-sectional study to investigate the relationships between these patient outcomes and other demographic and clinical variables in adult SCI patients discharged from the intensive care unit of an Italian tertiary rehabilitation hospital. We administered the Consultation and Relational Empathy (CARE) for perceived relational empathy, the Spinal Cord Independence Measure III self-report (SCIM-SR) for functional autonomy, the Numeric Rating Scale (NRS) for pain, and the Connor–Davidson Resilience Scale (CD-RISC-10) for resilience. Study participants consisted of 148 adults with SCI; 82.4% were male, with a mean age of 49.9 years (SD = 16.6). The lesion was traumatic in 82.4% and complete in 74.3% of cases. The median length of hospital stays was 35 days (interquartile range—IQR = 23–60). Perceived relational empathy was positively associated with resilience (r = 0.229, p = 0.005) and negatively associated with the length of the stay and lesion completeness. Resilience had a weak negative association with pain (r = −0.173, p = 0.035) and was unrelated to other variables. Clinicians should consider the routine assessment of PREMs and PROMs in order to personalize post-discharge therapeutic plans and identify appropriate measures to ensure continuity of care. [ABSTRACT FROM AUTHOR]

Simple Summary: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new surgical procedure used in the treatment of peritoneal surface malignancies (PSMs). Despite encouraging clinical results, the high costs of PIPAC and the need to repeat the treatment multiple times make the procedure difficult to sustain economically. A retrospective study was conducted in order to evaluate the cost of hospitalization for patients undergoing PIPAC treatment at a high-volume center in Italy. Currently, the Italian National Health System only partially covers the hospitals' costs. Therefore, there is an urgent need for an economical redefinition of this procedure, by creating dedicated reimbursement codes. PIPAC is a new surgical procedure and a viable treatment option for PSM patients, due to promising therapeutic outcomes, minimal invasiveness, limited surgical morbidity, and systemic toxicity side effects. However, its implementation throughout hospitals is hard to obtain due to its fragile economical sustainability. A retrospective health economic analysis was conducted in order to evaluate the cost of hospitalization for patients undergoing PIPAC treatment at Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, in Rome. The average cost of a PIPAC procedure was defined based on the cost of surgery (cost of surgical material, operating room, intraperitoneal chemotherapy), hospital stay, diagnostic examinations, and drugs used during the stay. A total of 493 PIPAC procedures were performed on 222 patients with peritoneal metastases or primary peritoneal cancer from 2017 to 2023. Since the mean remuneration for each PIPAC hospitalization is €5916 and the mean expenditure per hospitalization is €6538, this results in an operating profit per PIPAC hospitalization of −€622. The reimbursement of PIPAC treatment by the Italian National Health System currently only partially covers the hospital's costs. Development of specific codes and adequate reimbursement for PIPAC by recognizing this procedure as a proper treatment for peritoneal carcinomatosis is essential. [ABSTRACT FROM AUTHOR]

The main objectives of the present prospective clinical study were to evaluate the survival and success rates of implant-supported zirconia single crowns fabricated with a full digital workflow for the rehabilitation of mono- and bilateral agenesis of maxillary lateral incisors after 2 years of clinical function; biological and technical parameters affecting the prosthetic restorations were recorded, as well as the patient-satisfaction score. Twenty-two patients showing mono- or bilateral agenesis of the maxillary lateral incisors were included in this study, and a total of 30 narrow-diameter implants were inserted. Thirty screw-retained monolithic cubic zirconia single crowns with internal connections were fabricated. Objective outcome evaluations were performed by means of the Functional Implant Prosthodontic Score, whereas the patient-satisfaction score was evaluated using Visual Analog Scales. Descriptive statistics were performed and the Kaplan–Meier analysis was run to analyze time-to-event data. After 2 years of clinical function, the overall FIPS found in the present study was 9.2, whereas the average patient-satisfaction score was 8.7. The Kaplan–Meier analysis at the 2-year follow-up reported a cumulative survival rate of 100% and a cumulative success rate of 93.3%. The implant-prosthetic rehabilitation with a full digital workflow proved to be an effective and reliable procedure for the functional and aesthetic treatment of the agenesis of maxillary lateral incisors in the short-term. Clinical investigations with wider sample populations and longer observational follow-ups could be useful to validate, in the long-term, the clinical outcomes of the present prospective clinical study. [ABSTRACT FROM AUTHOR]

Background: Oncology nurses support cancer patients in meeting their self-care needs, often neglecting their own emotions and self-care needs. This study aims to investigate the variations in the five facets of holistic mindfulness among Italian oncology nurses based on gender, work experience in oncology, and shift work. Method: A cross-sectional study was carried out in 2023 amongst all registered nurses who were employed in an oncology setting and working in Italy. Results: There were no significant differences in all five facets of holistic mindfulness (p ≥ 0.05) according to gender, work experience in the oncology field, and shift work. Conclusion: Could holistic mindfulness be defined as an intrinsic individual characteristic? Surely, more insights will be necessary to better define the holistic trend in oncology nursing. [ABSTRACT FROM AUTHOR]

Congenital or acquired hand differences, including unilateral below-elbow deficiencies, present complex challenges in pediatric rehabilitation. Surgical management and prosthetic provision represent a big challenge to find a good balance for guaranteeing optimal hand function. There is no specific assessment tool for measuring these aspects in the Italian context. The present study investigates the psychometric properties of the ABILHAND-Kids in children with congenital unilateral below-elbow deficiencies and acquired amputation of the upper limb. We measure internal consistency using Cronbach coefficient alpha and the intraclass correlation coefficient (ICC) for measuring test-retest reliability. Differences in hand function in both children with acquired or congenital diseases were also investigated. Participants to the study were 107 (49 F and 58 M) children, with a mean (SD) age of 8.88 (4.25). For test retest reliability, conducted on a sub-sample of 58 children, the ICC was 0.92, while for internal consistency, the Cronbach coefficient alpha was 0.90. We did not find statistically significant differences in scoring (p = 0.33) in the use (mean 29.25 SD 6.58) or non-use of a prosthetic device (mean 30.74 SD 7.43), while statistically significant differences were found in hand function (p < 0.01) for children who had a congenital impairment (mean 31.87 SD 6.49) and children who had an acquired amputation (mean 27.77 SD 6.60). In conclusion, the ABILHAND-Kids showed good internal consistency and reliability and can capture differences in hand function in children with both congenital and acquired hand disorders. [ABSTRACT FROM AUTHOR]

Cyberbullying is a growing problem in the Italian educational sector, with a prevalence of 17%. This study analyzes its impact on the psychosocial well-being and academic performance of Italian adolescents. Method: A cross-sectional study was conducted with 502 students from six schools in different Italian regions, using the European Cyberbullying Intervention Project Questionnaire (ECIPQ) to assess cyberbullying, in addition to collecting data on satisfaction, friends, and academic performance. Chi-square and ANOVA analyses were conducted to identify significant associations between the variables. Results: The analyses showed significant associations between cyberbullying and gender and in psychosocial well-being, with significant differences in personal satisfaction and body satisfaction. On the other hand, there were no significant differences in academic performance or in the ability to make new friends, although victims showed a significantly lower ability to make new friends compared to those who were neither victims nor aggressors. Conclusions: Cyberbullying has a significant impact on students' psychosocial well-being, especially on personal satisfaction and school happiness, making it essential to implement interventions that promote safe school environments to mitigate these negative effects. [ABSTRACT FROM AUTHOR]

Background: Neonatal cerebral stroke includes a range of focal and multifocal ischemic and hemorrhagic brain lesions, occurring in about one of 3000 live births. More than 50% of children with neonatal stroke develop adverse outcomes, mainly unilateral cerebral palsy. Asymmetries in segmental movements at three months have been proven to be an early sign of CP in infants with unilateral brain damage. Recognition of additional early signs could enhance prognostic assessment and enable an early and targeted intervention. Aim: The aim of the study was to assess early signs of CP in infants with arterial cerebral stroke through the General Movements Assessment and the Motor Optimality Score—Revised (MOS-R). Method: Twenty-four infants born at term (12 females and 12 males) diagnosed with ACS, and 24 healthy infants (16 females and 8 males) were assessed. The GMs (fidgety movements) and MOS-R were assessed from videos recorded at 11–14 weeks of post-term age. Cognitive and motor outcomes were assessed at 24 months using the Griffiths III developmental quotient and Amiel-Tison neurological examination. The gross motor function classification system expanded and revised (GMFCS-E&R) was adopted to categorize CP. Results: Among infants with ACS, 21 (87.5%) developed unilateral CP. Most of them showed non-disabling CP (14 had GMFCS-E&R grade 1 [66.6%], 6 grade 2 [28.6%], and 1 grade 5 [4.8%]). Fidgety movements (FMs) were absent in 17 (70.8%), sporadic in 4 (16.7%) infants, and normal in 3 (12.5%). Segmental movement asymmetry was found in 22/24 (91.7%). According to the MOS-R, motor items (kicking, mouth movements), postural patterns (midline centered head, finger posture variability), and movement character (monotonous and stiff) were statistically different among infants with ACS and healthy infants. The MOS-R median global score was lower in the group with ACS compared to the control group (6 vs 26; p < 0.01). FMs, segmental movement asymmetry, and MOS-R global score were significantly correlated with abnormal outcome. MOS-R global scores less than or equal to 13 had 100% specificity and sensitivity in predicting GMFCS-E&R grade ≥ 2 CP in infants with ACS. Conclusions: The rate of CP was high among infants with ACS, but in most cases it showed low GMFCS-E&R grades. The study highlighted a significant correlation between MOS-R, together with absent FMs and unilateral CP in infants with ACS. Moreover, the MOS-R showed high sensitivity and specificity in the prediction of CP. Combined assessment of FMs and MOS-R could help to better identify infants at high risk of developing UCP in a population of infants with ACS. Early identification of precocious signs of unilateral CP is fundamental to providing an early individualized intervention. [ABSTRACT FROM AUTHOR]

Background: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguistically and culturally in the Italian context. Methods: Following Beaton et al.'s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire. Results: The Italian version demonstrates a good internal consistency and stability, making it suitable for assessing nursing students during clinical internships and practicing nurses. The availability of Italian tools promotes healthcare research, ensuring patient-centric care. Conclusions: The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has led to long-lasting consequences for workers leading to what has been termed a "psychological pandemic". Some categories, such as healthcare workers (HCWs), are considered high risk due to factors such as increased exposure and stressful working conditions. In this study, we investigate whether levels of posttraumatic stress symptoms and COVID-19-related fear (IES-6 and PSI-4) are associated with illness severity in a sample of 318 infected HCWs in Italy. To investigate the presence of different profiles of COVID-19 severity, Latent Class Analysis (LCA) was performed based on 11 symptoms. Differences in the IES-6 and PSI-4 scores across the latent classes were compared using the non-parametric Kruskal–Wallis (KW) test with Dunn's multiple comparison post hoc testing. Our analyses show that the LCA identified three classes of symptoms, reflecting no/low, mild and severe symptoms. The classes include vomiting, confusion, conjunctivitis, diarrhea, dyspnea, headache, ageusia, fever, anosmia, osteo muscle articular pain and asthenia. We found that HCWs who experienced more intense symptoms reported significantly higher IES-6 and PSI-4 scores. Moreover, we found gender-related differences in IES-6 and PSI-4 scores as females exhibited higher levels than males. Indeed, these findings are useful for developing health prevention and emergency management programs. [ABSTRACT FROM AUTHOR]

The present study aimed to explore the perceptions of spirituality and spiritual care among nurses who work in three different countries with different cultures as well as the factors influencing their perception. This is a cross-sectional multicultural study conducted with a total of 1090 nurses from Türkiye, Albania, and Italy. Data were collected through the "Individual Information Form" and the "Spirituality and Spiritual Care Rating Scale". Nurses' mean score on the Spirituality and Spiritual Care Rating Scale was above average. It was also found that country, marital status, religious belief, Islamic religion, training for spiritual care, and using spiritual practices to cope with difficulties or illnesses influenced nurses' perception of spirituality and spiritual care. It was concluded that nurses from the three countries associated spirituality and spiritual care with religion and that some personal characteristics influenced their perceptions of spiritual care. The results highlight the need for training in spiritual care to improve nurses' perceptions and practices of spiritual care. [ABSTRACT FROM AUTHOR]

Introduction: The image of a nurse is a source of concern due to its impact on recruitment into the profession, political decisions about the profession, and how the image affects nursing practice. For these reasons, one of the long-term challenges is to assess and maintain a favorable public image that respects the utility and value of the nursing profession. Aim: This study aims to validate an instrument for assessing the image of the nurse as perceived by Italian citizens. Methods: A non-probabilistic sample of 564 people participated in the study between 2022 and 2023. Sociodemographic information of the Italian citizens was collected, and the instrument used to evaluate the perceived public image was the Nursing Attitudes Questionnaire (NAQ). The psychometric properties of the Italian version of the NAQ (NAQ-IV) were calculated using Cronbach's alpha, item–total correlations, skewness, and kurtosis. Factor analysis was performed using principal axis factoring and the varimax rotation method. Results: Factor analysis revealed a four-factor model explaining more than 60.52% of the variance, with the largest variance explained by the "Role and Professionalism" factor (34.08%). The internal consistency calculation showed a Cronbach's alpha of 0.89 for the scale and between 0.88 and 0.89 among the factors; all the items verified the item–total correlation and response variability criteria. Conclusions: The NAQ-IV could be a valid tool for assessing the perception of Italian citizens. However, further studies are recommended to evaluate the reliability of the instrument, especially in the evolving professional profile and social health welfare. [ABSTRACT FROM AUTHOR]

Simple Summary: With the increase in the mastectomy rate, the number of patients opting for postmastectomy reconstruction has been rising, with implant-based procedures being the most commonly used method. One of the most feared complications is the loss of reconstruction, often caused by implant infection. This can lead to prolonged antibiotic treatments, additional surgical procedures, capsular contracture, and unsatisfactory aesthetic results, with a significant psychological impact on patients. This study analyzed infection rates at our institution and evaluated the effectiveness of our prevention protocol introduced in 2020, comparing the data on surgical site infections (SSIs) between Trieste Hospital (with the protocol) and another center in Gorizia (without the protocol). We enrolled 396 patients, divided into the experimental group (Trieste) and the control group (Gorizia). Infected patients were 5 in the first group (1.7%) and 8 in the second group (7.9%), with an overall infection rate of 3.2%. We conclude that the prevention protocol has reduced the incidence of postoperative infections. Background: With the rise in the mastectomy rate, the number of patients who choose to undergo postmastectomy reconstruction has been increasing, and implant-based procedures are the most performed methods for postmastectomy breast reconstruction. Among the possible complications, the most feared is the loss of reconstruction. It can be related to several reasons, but one of the most common is infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, increased incidence of capsular contracture, and unsatisfactory aesthetics results, with a huge psychological impact on patients. Aims: The primary intent of this study is to analyze the status of infection rates at our institution and evaluate the effectiveness of our prevention protocol since its introduction. Secondly, we compared data of the surgical site infections (SSIs) after implant-based breast reconstruction at Trieste Hospital, where the protocol has been employed since 2020, and in another center, where plastic surgeons of our team are involved, with different prevention procedures. Methods and Results: We enrolled 396 female patients, who underwent implant-based breast reconstruction, using definitive mammary implants or breast tissue expanders, with or without ADM (acellular dermal matrix), both for breast cancer and risk-reducing surgery in BRCA1/2 patients. Patients treated at the Hospital of Trieste, with the use of the prevention protocol, were considered the experimental group (group 1), while patients treated in Gorizia by the same breast team with standardized best-practice rules, but without the use of the prevention protocol, were considered the control group (group 2). Infected patients were 5 in the first group (1.7%) and 8 in the second one (7.9%), with a global infection rate of 3.2%. Conclusion: After the introduction of our prevention protocol, we faced a lower incidence of infection after breast surgery with implants or tissue expanders. [ABSTRACT FROM AUTHOR]

Simple Summary: Colorectal cancer remains a prevalent neoplasm affecting both genders. Despite advancements in screening techniques facilitating early detection, effective patient management remains paramount. This study investigates the impact of a multidisciplinary team (MDT) approach on patient outcomes. Results reveal a significant improvement in survival rates among MDT-followed patients compared to those lacking MDT oversight. Notably, no-MDT patients exhibited a twofold increase in mortality risk from both colon and rectal cancers. Furthermore, advanced age (>70 years) and advanced-stage disease (III and IV) emerged as pivotal risk factors. Consequently, prioritizing MDT intervention for these high-risk cohorts is imperative to optimize therapeutic strategies. Colorectal cancer emerged as the third most prevalent malignancy worldwide, affecting nearly 2 million individuals in the year 2020. This study elucidates the pivotal role of a multidisciplinary team (MDT) in influencing the prognosis, as measured by relative survival rates, depending upon the stage and age. Cases recorded in an Italian Cancer Registry between 2017 and 2018 were included. Relative survival was reported at 1 and 3 years after diagnosis comparing MDT vs. no-MDT approaches. During the study period, 605 CRCs were recorded while 361 (59.7%) were taken care of by an MDT. Compared to no-MDT, MDT patients were younger with earlier stages and received more surgery. One year after diagnosis, survival was 78.7% (90% in MDT vs. 62% in no-MDT); stratifying by stage, in the MDT group there was no survival advantage for stage I (97.2% vs. 89.9%) and II (96.8% vs. 89.4%), but an advantage was observed for stage III (86.4% vs. 56.9%) and stage IV (63.7% vs. 27.4%). Similar values were observed at 3 years where a marked advantage was observed for stages III (69.9% vs. 35.1%) and IV (29.2% vs. 5.1%). The univariable analysis confirmed an excess risk in the no-MDT group (HR 2.6; 95% CI 2.0–3.3), also confirmed in the multivariable regression analysis (HR 2.0; 95% CI 1.5–2.5). Despite the increase in the number of MDT patients in 2018 (from 50% to 69%), this does not correspond to an improvement in outcome. [ABSTRACT FROM AUTHOR]

Ability, knowledge, aptitude, and skill are the terms identified in the literature as the attributes of the concept of clinical competence. This implies that in order to act competently in their own context, the nurse must be able to make decisions which mainly depend on the ability to put clinical reasoning into practice. However, the evaluation of clinical reasoning in the various clinical-care activities of nursing competence is a necessary operation to prevent routine attitudes. From the perspective of an assessment of nursing competences, the aim of this study is to validate the relationship between the degree of competence recognized in a specific clinical setting and the amount of clinical reasoning executed by nurses. The study design was a cross-sectional observational design, following the guidelines of the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) of observational studies. Both the Italian Nurse Competence Scale and the Nurse Clinical Reasoning Scale were used. The data was collected between 25 January and 5 March 2022. Four hundred twenty-four clinical nurses participated by completing and returning the questionnaires. The instruments underwent assessment to ensure internal consistency and test–retest reliability. Their validity was tested with the validity of known content, construct, and groups. This is supported by statistically significant correlations between the different variables examined and the scores of the different dimensions of the Italian Nurse Competence Scale and the Italian Nurse Clinical Reasoning Scale. The data collected showed an excellent average level of competencies and clinical reasoning, M = range of 72.24 and 63.93, respectively. In addition, we observed satisfactory scores across all dimensions of I-NCS (significance range: 0.000–0.014) and I-NCRS (significance range: 0.000–0.004). The understanding and development of clinical reasoning has also brought out new aspects that require further research. This study provides a fresh perspective on the correlation between clinical competences and clinical reasoning, representing a novel attempt to analyze their relationship. [ABSTRACT FROM AUTHOR]

Background: Assessment of upper limb function is critical in the rehabilitation process of people with Parkinson's Disease (PD), and universally validated outcome measures are needed to allow comparisons across the practice. Moreover, the study of psychometric properties of the same tool on different clinical populations guarantees the possibility of reliably evaluating the same rehabilitation treatment in people with different clinical conditions. Aim of the study: The aim of this research was to evaluate the psychometric characteristics of the Italian adaptation of the Jebsen Taylor Hand Function Test (JTHFT) in individuals with PD. Methods: The reliability and validity of the test were assessed in accordance with international standards. Internal consistency was measured using Cronbach's alpha, and test–retest reliability was determined via the intraclass correlation coefficient (ICC). The construct validity and cross-cultural validity of the test were evaluated using Pearson's correlation coefficient with three assessment tools on upper limb function, independence, and quality of life, with hand grip power measured by a dynamometer and an Italian pangram. Finally, responsiveness after a one month of rehabilitation treatment was measured using the Wilcoxon rank test. Results: Fifty-two Italian people with PD were recruited. Cronbach's alpha values ranged from 0.556 (non-dominant hand) to 0.668 (dominant hand); ICC values ranged from 0.754 to 0.988. Construct validity showed that several statistically significant correlations were detected. Wilcoxon's test showed that the assessment tool can detect a change in this population after treatment. Conclusions: The JTHFT is a reliable, valid, and respondent tool to evaluate the upper limb and hand functionalities in PD patients. It should be added to the toolkit for measuring upper limb performance in this population, adding value to clinical evaluation and ensuring comparable results for different clinical populations and different countries. [ABSTRACT FROM AUTHOR]

Delirium is highly prevalent among hospitalized older adults and is associated with unfavorable outcomes. However, delirium often remains undiagnosed in the hospital context. Having a valid, simple, and fast screening tool could help in limiting the additional workload for healthcare professionals, without leaving delirium undetected. The aim of this study was to estimate the sensitivity and specificity of the Recognizing Acute Delirium As part of your Routine (RADAR) scale in an Italian hospital. An observational cross-sectional study was conducted. A total of 150 patients aged ≥70 years were enrolled. Receiver operating characteristic (ROC) curves using the Confusion Assessment Method (CAM) criterion-defined delirium as the gold standard were plotted to evaluate the performance of the RADAR scale. The cut-off suggested by previous research was used to estimate the sensitivity, specificity, and positive and negative predictive values of the RADAR scale. The involved patients were mostly females (60%; n = 90), with a median age of 84 years (I–III quartiles: 80–88). According to the CAM and the RADAR scale, 37 (25%) and 58 (39%) patients were classified as experiencing delirium, respectively. The area under the ROC curve of the RADAR scale was 0.916. Furthermore, the RADAR scale showed robust sensitivity (95%), specificity (80%), and positive (60%) and negative predictive values (98%). The RADAR scale is thus suggested to be a valid tool for screening assessment of delirium in hospitalized older adults. [ABSTRACT FROM AUTHOR]

Background: Megaprostheses were first employed in oncological orthopedic surgery, but more recently, additional applications have arisen. These implants are not without any risks and device failure is quite frequent. The most feared complication is undoubtedly the implants' infection; however, the exact incidence is still unknown. This systematic review aims to estimate in the current literature the overall incidence of megaprosthesis infections and to investigate possible risk/protective factors. Methods: We conducted a systematic search for studies published from July 1971 to December 2023 using specific keywords. To be included, studies needed to report either the megaprosthesis anatomical site, and/or whether the megaprosthesis was coated, and/or the surgical indication as oncological or non-oncological reasons. Results: The initial literature search resulted in 1281 studies. We evaluated 10,456 patients and the overall infection rate was 12%. In cancer patients, the infection rate was 22%, while in non-oncological patients, this was 16% (trauma 12%, mechanical failure 17%, prosthetic joint infections 26%). The overall infection rates comparing coated and uncoated implants were 10% and 12.5%, respectively. Conclusions: The number of megaprosthesis implants is increasing considerably. In traumatological patients, the infection rate is lower compared to all the other subgroups, while the infection rate remains higher in the cancer patient group. As these devices become more common, focused studies exploring epidemiological data, clinical outcomes, and long-term complications are needed to address the uncertainties in prevention and management. [ABSTRACT FROM AUTHOR]

Background: In 2020, a multiprofessional panel was set up in collaboration with the Italian FightTheStroke Foundation family association to produce evidence-based recommendations for the management and neuromotor rehabilitation of persons with cerebral palsy aged 2–18 years to implement in clinical practice in Italy. Methods: The recommendations of these care pathways were developed according to the American Academy for Cerebral Palsy and Developmental Medicine guidelines for Care Pathways Development and the Grading of Recommendations Assessment Development and Evaluation working group for adoption, adaptation, or de novo development of recommendations from high-quality guidelines (GRADE-ADOLOPMENT). Results: Four strong positive recommendations were developed regarding comprehensive management, and twenty-four addressed neuromotor treatment. Conclusions: A holistic, individualized approach was affirmed in terms of both multidimensional patient profile and interdisciplinary management in a network with the school where children and adolescents are integrated. It was defined that all motor rehabilitation approaches must be individually tailored considering age and developmentally appropriate activities as interventions and goals, in light of the reference curves addressing prognosis for Gross Motor Function and Manual Ability Classification Systems. Intervention must be structured with adaptations of the task and/or of the context (objects and environment) based on the analysis of the child's skills to support motivation and avoid frustration. [ABSTRACT FROM AUTHOR]

Background: Children with medical complexity (CMC) often require multiple medications, leading to polypharmacy, which seems to be linked to adverse effects, administration errors, and increased caregiver burden. This study aimed to describe the prevalence of polypharmacy, medication burden, off-label drug use, and associated costs. Methods: Conducted at the Pediatric Palliative Care Center of Padua, Italy, from August to October 2021, this cross-sectional observational study included patients up to 23 years old with at least one prescribed drug. Data were collected from medical records and caregiver interviews. Drug costs were collected from the Italian Medicine Agency. Descriptive statistical analysis was performed. For comparisons among categorical variables, the Chi-square test was used, and for those among continuous variables, the ANOVA test was used. Results: This study analyzed treatment regimens of 169 patients with a median age of 12.5 years (0.3–23). Polypharmacy was present in 52.7% of patients, and medication burden was observed in 44.4%, both varying significantly by primary diagnosis (p < 0.001). The median daily cost per patient was EUR 2.2 (IQR 0.9–7.1), with significant variation among subgroups. Only 34.6% of prescriptions were off-label. Conclusions: polypharmacy and medication burden are frequent among our CMC population, with some differences according to primary diagnosis. [ABSTRACT FROM AUTHOR]

Background: Post-pandemic psychosomatic complaints in children and adolescents have been underreported. This study investigated psychosomatic complaints in children and adolescents in Northern Italy in 2023, with the aim of identifying changes in predictors and vulnerable subgroups. Methods: Cross-sectional data representative of scholars from a northern Italian province were analyzed using the Health Behavior in School-aged Children (HBSC) checklist. The sum scores, count data, and dichotomized data were examined, and predictor effects were expressed using a linear regression model for the sum scores. Results: Data from 4525 participants (aged 7–19 years, 50.5% girls) were analyzed. Psychosomatic symptoms remained unchanged after the pandemic. Significant gender differences were noted, especially in older age groups, with girls reporting more complaints. Factors such as children's health, digital media use, and school problems significantly influence psychosomatic outcomes. While migration background negatively affected girls' psychosomatic well-being, boys showed improvement through sports. Conclusion: The psychosomatic well-being of children and adolescents did not improve after the pandemic. These findings indicate the need for targeted interventions, improved health literacy, and ongoing monitoring to support the mental well-being of this vulnerable population. Reducing screen time remains a critical strategy for enhancing youth well-being. [ABSTRACT FROM AUTHOR]

Background: Body image perception can significantly influence various aspects of adolescent lives. The study analyzed the relationship between body image satisfaction and sports participation in adolescents, examining various factors that contribute to body image concerns and their implications for sports engagement. Methods: A total of 237 schoolchildren were recruited from lower secondary Italian schools. Anthropometric characteristics were measured directly. Assessment of body image perception was performed using Body Silhouette Charts for preadolescent children. The Italian version of the International Physical Activity Questionnaire for Adolescents questionnaire was administered to assess physical activity (PA) levels at school and during leisure time in the last 7 days. Analysis of variance was used to test differences in PA levels, while multiple regression models were carried out to assess possible predictors of body dissatisfaction. Results: In total, 42.6% of children were not satisfied with their figure and 23.2% were very dissatisfied; among them, the vast majority would have liked to be thinner. The dissatisfaction and satisfaction were similar in boys and girls. The frequency of satisfaction with one's body image was higher in children who practiced extracurricular sports compared to those who did not. The percentage of dissatisfaction with one's body image was similar in the two groups, but the frequency of children being very dissatisfied was double in the group that does not practice extracurricular sport (31.2% vs. 17.7%). Body dissatisfaction increases with increasing body mass index in both genders but decreases in children involved in extracurricular sports. Conclusions: Encouraging teenagers to engage in regular physical activity should be a key component of therapies supporting positive body image. This study found a relationship between extracurricular sports and body image satisfaction, suggesting that physical activity protects teenagers' body image satisfaction. [ABSTRACT FROM AUTHOR]

(1) Background: Body image dissatisfaction has been commonly reported in adolescents with overweight/obesity and has been related to a lack of motivation to change lifestyle behaviors. Plus, a better perception of physical fitness has been related to a higher self-perception in physical aspect and social items in youths. (2) Methods: A total of 120 (59.2% males, mean age of 12.3 ± 0.9 years) middle-school adolescents participated in the present study. Anthropometric measurements were assessed following the standard procedures. Body weight perception and body image satisfaction were assessed using the Silhouette Figure Body Images Test. Self-perception profile, perceived physical fitness, and perceived difficulties in conducting physical tasks were assessed by using structured questionnaires. (3) Results: Overweight was present in 27.5% adolescents and obesity in 32.5%. A total of 89.7% of adolescents with obesity did not have a real perception of his/her weight status and 84.6% of adolescents with obesity were not satisfied with his/her body image. The self-perception of physical appearance, perceived difficulties in running, perceived overall fitness, and perceived speed/agility were lower in adolescents who were unsatisfied with their body image. Body image satisfaction was positively associated with the self-perception of physical appearance and overall fitness and negatively associated with perceived difficulties in running, independently of sex, age, and BMI. (4) Conclusions: Adolescents with obesity did not have a real perception of their weight status and were unsatisfied with their body image. The positive association between body satisfaction, a better perception of overall fitness, and less difficulties in conducting physical tasks suggests the protective role of the components of physical activity and health-related fitness on body acceptance in a critical period of life. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is among the most prevalent disorders in children and is frequently linked with motor difficulties that can impact both daily motor tasks and overall developmental trajectories. The objective of this study was to analyse the association between gross motor skills and ADHD symptoms. Using a cross-sectional research design, data were collected from a sample of primary school children (N = 2677; mean age = 8.58 years, SD = 1.49 years). The Gross Motor Development-3 Test (TGMD-3) was employed to assess participants' gross motor skills, whereas the ADHD Rating Scale (SDAI), completed by teachers, evaluated ADHD symptoms through two subscales: inattention and impulsivity/hyperactivity. The results revealed an association between motor development and ADHD symptoms, with greater proficiency in gross motor skills correlating with lower symptoms reported on the SDAI. Logistic regression analyses indicated that the TGMD-3 was significantly associated with the risk of ADHD in matched samples of at-risk children and controls. The evaluation of gross motor development proves to be a useful tool for monitoring global development, paying attention to any critical issues, particularly in relation to the variables of inattention and hyperactivity. [ABSTRACT FROM AUTHOR]

Simple Summary: "Surgery-first" is the main paradigm of treatment for intracranial meningiomas, with the aim of maximal safe tumor resection while preserving the neurological function. This purpose is not always achievable for meningiomas involving the spheno-orbital region, due to their close anatomical relationship with highly functional neurovascular structures, which limits the extent of resection. Therefore, surgery aims to achieve an onco-functional balance, mainly addressed to symptoms and signs of resolution. For this purpose, several surgical approaches, each with related pros and cons, can be considered. Surgery stands as the primary treatment for spheno-orbital meningiomas, following a symptoms-oriented approach. We discussed the decision-making process behind surgical strategies through a review of medical records from 80 patients who underwent surgical resection at the University of Naples Federico II. Different surgical approaches were employed based on the tumor's location relative to the optic nerve's long axis, categorized into lateral (type I), medial (type II), and diffuse (type III). We examined clinical, neuroradiological, surgical, pathological, and outcome factors. Proptosis emerged as the most frequent symptom (97%), followed by visual impairment (59%) and ocular motility issues (35%). Type I represented 20%, type II 43%, and type III 17%. Growth primarily affected the optic canal (74%), superior orbital fissure (65%), anterior clinoid (60%), and orbital apex (59%). The resection outcomes varied, with Simpson grades I and II achieved in all type I cases, 67.5% of type II, and 18% of type III. Recurrence rates were highest in type II (41.8%) and type III (59%). Improvement was notable in proptosis (68%) and visual function (51%, predominantly type I). Surgery for spheno-orbital meningiomas should be tailored to each patient, considering individual characteristics and tumor features to improve quality of life by addressing primary symptoms like proptosis and visual deficits. [ABSTRACT FROM AUTHOR]

Simple Summary: The epidemiology of primary liver cancer is changing according to effective primary prevention interventions, a strictly clinical follow up of chronic patients with hepatitis and successful drug treatments of virus-related liver diseases. A reduction in virus-related hepatocellular carcinomas cases was followed by an increase in the non-viral aetiology, including metabolic and cryptogenetic factors. We used cancer surveillance data to investigate determinants potentially associated with primary liver cancer survival in a southern Italian setting characterised by a high prevalence of hepatitis viral infections and overweight and obesity. Our study provided some new insights into the potential relationship between deprivation, geographic location, access to care and hepatocarcinoma survival. Comprehensive national and regional health plans should consider the evidence provided to ensure equitable access to prevention and care pathways. While entering the digital prevention era, interoperating cancer registries with other sources providing data on lifestyles and health determinants should be promoted. A retrospective observational study utilising cancer incidence data from a population-based registry investigated determinants affecting primary liver cancer survival in a southern Italian region with high hepatitis viral infection rates and obesity prevalence. Among 2687 patients diagnosed between 2006 and 2019 (65.3% male), a flexible hazard-based regression model revealed factors influencing 5-year survival rates. High deprivation levels [HR = 1.41 (95%CI = 1.15–1.76); p < 0.001], poor access to care [HR = 1.99 (95%IC = 1.70–2.35); p < 0.0001], age between 65 and 75 [HR = 1.48 (95%IC = 1.09–2.01); p < 0.05] or >75 [HR = 2.21 (95%CI = 1.62–3.01); p < 0.0001] and residing in non-urban areas [HR = 1.35 (95%CI = 1.08–1.69); p < 0.01] were associated with poorer survival estimates. While deprivation appeared to be a risk factor for primary liver cancer patients residing within the urban area, the geographic distance from specialised treatment centres emerged as a potential determinant of lower survival estimates for residents in the non-urban areas. After balancing the groups of easy and poor access to care using a propensity score approach, poor access to care and a lower socioeconomic status resulted in potentially having a negative impact on primary liver cancer survival, particularly among urban residents. We emphasise the need to interoperate cancer registries with other data sources and to deploy innovative digital solutions to improve cancer prevention. [ABSTRACT FROM AUTHOR]

Simple Summary: The present study aimed to evaluate the age-related distribution of HPV 16/18 genotypes and non-16/18 HPV genotypes in unvaccinated women. CIN3 in women younger than 30 years was significantly associated with HPV16/18 genotypes. The surprising fact of the present study is represented by the fact that in women under the age of 30, almost 90% of CIN3 cases were associated with HPV16/18, while CIN3 with non-16/18 HPV genotypes develops slowly and in older age. The data from the present study suggest that the risk of CIN3 is related to the woman's age and hr HPV genotype. These data are essential to optimize current and future screening programs. Background. The objective of the present study is to investigate the age-specific distribution of HPV genotypes in CIN3 lesions in screened unvaccinated women. These data are essential to optimize current and future screening programs. Methods. A multicenter retrospective study was conducted. A total of 408 unvaccinated women with positive histology and a high-risk HPV genotype were enrolled. Each woman at baseline had HPV DNA testing and HPV genotyping, and all women underwent targeted biopsy and/or treatment with a loop electrosurgical excision procedure (LEEP) before entering the study. We divided the genotypes into HPV16/18 and HPV non-16/18 (HPV31/33/45/35/39/51/52/58/59/66/68). Women were divided into increasing age categories: <30, 30–44, and ≥45. Results. The percentage of CIN3 associated with HPV16/18 is maximum in women under 30 years of age (85.1%), drops to 75.6% in women aged between 30 and 44 years, and up to 47.2% in women over 45 years. CIN3 in women younger than 30 years was significantly associated with HPV16/18 genotypes (p = 0). Discussion. The data from the present study suggest that the risk of CIN3 is related to the woman's age and hr HPV genotype. The data highlight two different types of CIN3: a more frequent type, related to HPV16/18, which develops rapidly and in young women, and another, relating to non-16/18 HPV, which develops later at an advanced age and slowly, through low-grade lesions. [ABSTRACT FROM AUTHOR]

Simple Summary: Rehabilitation might play a crucial role in malignant pleural mesothelioma (MPM), but its role is still debated in MPM patients. The intervention comprised multidisciplinary educational sessions, physical rehabilitation, and respiratory physiotherapy. Feasibility was evaluated based on dropout rates, adherence to the rehabilitation program, safety, and patient-reported outcomes. In light of the current evidence, we have conducted a pilot study to assess the feasibility of tailored pulmonary rehabilitation in terms of physical and respiratory function in MPM. Twelve patients were initially enrolled, with seven completing the study. High adherence to physical (T1: 93.43%, T2: 82.56%) and respiratory (T1: 96.2%, T2: 92.5%) rehabilitation was observed, with minimal adverse events reported. Patient satisfaction remained high throughout the study (GPE scores at T1: 1.83 ± 1.17; T2: 2.0 ± 1.15), with improvements noted in physical function, pain management, and health-related quality of life. Despite its promising outcomes, further research with larger samples is warranted to validate its efficacy and integrate rehabilitation as a component into the multidisciplinary management of MPM. Malignant pleural mesothelioma (MPM) represents a significant health burden, with limited treatment options and poor prognosis. Despite advances in pharmacological and surgical interventions, the role of rehabilitation in MPM management remains underexplored. This study aims to assess the feasibility of a tailored pulmonary rehabilitation intervention addressing physical and respiratory function in MPM patients. A prospective pilot study was conducted on surgically treated MPM patients referred to a cardiopulmonary rehabilitation service. The intervention comprised multidisciplinary educational sessions, physical rehabilitation, and respiratory physiotherapy. Feasibility was evaluated based on dropout rates, adherence to the rehabilitation program, safety, and patient-reported outcomes. Twelve patients were initially enrolled, with seven completing the study. High adherence to physical (T1: 93.43%, T2: 82.56%) and respiratory (T1: 96.2%, T2: 92.5%) rehabilitation was observed, with minimal adverse events reported. Patient satisfaction remained high throughout the study (GPE scores at T1: 1.83 ± 1.17; T2: 2.0 ± 1.15), with improvements noted in physical function, pain management, and health-related quality of life. However, some issues, such as time constraints and lack of continuous supervision, were reported by participants. This pilot study demonstrates the feasibility and potential benefits of a tailored pulmonary rehabilitation intervention in MPM patients. Despite its promising outcomes, further research with larger samples is warranted to validate its efficacy and integrate rehabilitation as a component into the multidisciplinary management of MPM. [ABSTRACT FROM AUTHOR]

The management of gastric Helicobacter pylori (H. pylori) infection represents a significant concern in primary healthcare. This survey evaluates the approaches, attitudes, and knowledge regarding gastric H. pylori infection among Italian general practitioners (GPs) and young doctors undergoing general practice training (ITGPs). The survey enrolled 466 GPs and 70 ITGPs. Among GPs, specialist recommendations and the Maastricht–Florence guidelines were frequently referenced sources, while ITGPs relied more on the Maastricht–Florence guidelines and internet resources. ITGPs demonstrated more proactive approaches than GPs in investigating and treating conditions such as gastric ulcers, atrophic gastritis, and iron-deficiency anemia. However, there was limited attention given to the role of H. pylori treatment in first-degree relatives of gastric cancer patients. The most used diagnostic methods were the urea breath test and fecal test. Triple therapy was the most frequently chosen initial treatment regimen, with quadruple bismuth therapy becoming the primary option after initial treatment failure, followed by quinolone therapy and concomitant therapy. This survey underscores a disparity between real-world practices and the recommendations outlined in current guidelines, indicating a need for improved understanding of H. pylori guidelines among both GPs and ITGPs. [ABSTRACT FROM AUTHOR]

This study describes and explores the application of no-restraint policies in General Hospital Psychiatric Units (GHPUs) in Italy, a country pioneering in deinstitutionalization and psychiatric reform. The research aims to assess the organizational characteristics and effectiveness of no-restraint practices, contributing to the global discourse on humane psychiatric care. Following a purposive sampling approach, a nationwide descriptive study was conducted involving a detailed online survey distributed to 24 GHPUs actively engaged in or aspiring toward no-restraint practices. The survey, comprising 60 items across seven sections, gathered comprehensive data on the structural, organizational, and operational dimensions of the units, along with the prevalence and management of restraint episodes. Results reveal a significant commitment to no-restraint policies, with 14 GHPUs reporting zero restraint incidents in 2022. Despite variations in infrastructure and staffing, a common thread was the implementation of systematic procedures and risk management training aimed at reducing coercive practices. The study identified a correlation between the use of exclusive garden spaces and an increased incidence of restraints, suggesting nuanced factors influencing restraint practices. The findings underscore the viability and ethical alignment of no-restraint practices within psychiatric care, highlighting the crucial role of organizational protocols and training. This research adds empirical weight to the advocacy for restraint-free environments in mental health settings, signaling a paradigm shift toward more humane and rights-respecting psychiatric care. [ABSTRACT FROM AUTHOR]

Background: Music Therapy (MT) is a non-pharmacological, art-based intervention that employs music experiences within a therapeutic alliance to attend to clients' physical, emotional, cognitive, and social requirements. This is the first study aiming at investigating the impact of MT on the psychological facets of children suffering from cancer. Methods: The study, combining the AQR and m-YPAS assessment tools, evaluated behavioral, sound–musical, and interactive parameters in pediatric oncology patients undergoing MT sessions during hospitalization. Fifty patients admitted to the Paediatric Oncology and Haematology Unit at Policlinico S. Orsola Hospital in Bologna, Italy, were enrolled, irrespective of their treatment regimen. Data collection occurred on the first day of the MT session between 3 p.m. and 5 p.m., with observations conducted by independent observers. In addition to traditional statistical analysis, network analysis was used to explore the combined interactions of all parameters, effectively discerning the distinctive roles played by each one during therapy sessions and their influence on all others. Results: Network analysis highlighted distinct patterns of interactions among parameters during the various sessions, emphasizing the role of positive emotions and a calm setting, the child's ability to take the initiative in sessions, their sense of agency, and the parent's role in guiding them. Significant differences were recorded at each time point between all variables considered. Conclusions: The results of this innovative study may pave the way for future multicenter studies aimed at further exploring the role of MT in children undergoing both curative and palliative treatments for cancer. [ABSTRACT FROM AUTHOR]

Background: Alternative Disputes Resolution (ADR) systems are becoming increasingly important tools in recent years for the management and resolution of health responsibility cases, but their dissemination and efficiency are still poorly described. The purpose of this paper is to present an ADR system in the autonomous province of Bolzano: the Conciliation Commission. Methods: systematic collection of all claims of the South Tyrol Sanitary Service that were dealt with in the Conciliation Commission from 1 January 2012 to 31 December 2022. Results: closing times of the applications received turn out to be less than a year in 63.8% of the cases, with a number of cases managed rather stably in the time, even if minimal if compared to the number of complaints received to the South Tirol Health Service. Only 5.3% of the application continued the legal process before a civil court. Conclusions: the Conciliation Commission of South Tirol appears to be an excellent instrument for the resolution of disputes in the healthcare field, with rapid resolution times and little to zero costs for the healthcare company, a public health institution. Despite its effectiveness, it seems to be a tool that is still little-known in South Tyrol. [ABSTRACT FROM AUTHOR]

Nursing retention is a major challenge globally. Ongoing workforce instability across countries underscores the need to understand the factors influencing turnover and nursing retention. Trust is a crucial element in managing workplace relationships between nurse managers and nurses. Existing studies have shown the direct impact of trust on employees' intention to leave their job but have not explored the effects of potential mediators such as organizational commitment. The aim of this study was to examine the impact of trust in the leader on nurses' intention to leave their job through the mediation of organizational commitment. A cross-sectional study was conducted in Italy. A convenience sample of 1853 nurses completed a self-report survey. The study tested a hypothesis-based mediation model using structural equation modeling, which showed good fit indices. The results indicated that trust in the leader had a significant impact on nurses' intention to leave, and this relationship was partially mediated by organizational commitment. Nurses who trust their leader are more likely to demonstrate higher levels of organizational commitment, resulting in a lower intention to leave their job. Furthermore, organizational commitment and trust emerge as critical factors in reducing nurses' intention to leave their current positions. Therefore, managers can reduce nurses' intention to leave by building trustful relationships that enhance organizational commitment.This study was not registered. [ABSTRACT FROM AUTHOR]