Igiene e sanita pubblica最新文献

{"title":"Nursemaid's Elbow in Children: Proposal of a Preventive Strategy in the Digital Era.","authors":"Mauro Menichelli, Francesca Tarquini, Matteo Renzi, Marco Nasnini, Riccardo Pallotta, Gloria D'Angelo, Stefano Marcelli, Chiara Gatti","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Nursemaid's elbow, or painful pronation of the elbow, is a common orthopedic condition in children aged 0-5 years. It is typically caused by sudden traction on the forearm, leading to subluxation of the radial head. Despite its benign nature and straightforward treatment, the condition remains frequent, largely due to insufficient awareness among parents and caregivers. Preventive strategies, including health education, are essential to reduce incidence and recurrence. Objective The primary objective of this study was to evaluate the level of knowledge and awareness of nursemaid's elbow among parents and caregivers in Italy. The secondary objective was to promote preventive measures through educational interventions, particularly focusing on safe alternatives to risky practices such as lifting children by the wrists or performing the \"vola-vola\" game. Material and Methods A descriptive observational study was conducted in three phases: (1) a pilot study to validate the questionnaire, (2) administration of the definitive questionnaire via social platforms, and (3) dissemination of an educational video. The pilot questionnaire was tested on 100 participants to assess clarity, comprehensibility, and privacy compliance. The final questionnaire, consisting of 13 closed-ended items, was distributed between November 2024 and February 2025 to parents of children aged 0-5 years. Data were analyzed using IBM SPSS Statistics v31, applying binomial tests, Fisher's exact test, and internal consistency analysis. The educational video was shared on Facebook, Instagram, and LinkedIn, and its impact was measured through visualization metrics. Results The pilot study confirmed the validity of the questionnaire, with over 90% of participants rating it clear and comprehensible. In the main survey, 45.5% of parents reported lifting children by the wrists, and 74.8% admitted practicing the \"vola-vola\" game. Although 64.9% perceived the practice as potentially harmful, only 38.3% had received explicit advice against it. Knowledge of nursemaid's elbow was limited: 49.5% had heard of it, but fewer understood its causes (45.3%) or recognized its clinical signs (38.1%). Only 6.3% reported direct episodes in their children, with a high recurrence rate (94.9%). The educational video reached 5799 views, with Facebook accounting for the majority (3549), particularly among adults aged 25-44 years. Discussion The findings highlight a significant gap between risk perception and preventive communication. International literature confirms similar trends, with recurrence rates up to 14% and widespread lack of awareness. Imaging is generally unnecessary for diagnosis, except in atypical cases. Preventive education remains the cornerstone of reducing incidence. Conclusions Nursemaid's elbow continues to be a frequent condition in early childhood, exacerbated by insufficient parental knowledge. Educational campaigns targeting parents, teachers, and caregivers are cruci","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"98 6","pages":"357-365"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A challenge to improve the Quality of Care.Rehabilitation outcome measures in the Emergency Department: a scoping review.","authors":"Giovanni Galeoto, Maria Rita Molinari, Loredana Gigli, Emanuele Amadio, Giovanni Sellitto, Annamaria Servadio","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The integration of physiotherapists within Emergency Departments (EDs) is increasing internationally; however, the outcome measures employed in this setting remain heterogeneous and largely non-standardized.</p><p><strong>Objective: </strong>To map and describe clinical, functional, psychological, prognostic, and patient experience outcome measures currently used by physiotherapists working in EDs.</p><p><strong>Methods: </strong>A scoping review was conducted following PRISMA-ScR guidelines. PubMed and Google Scholar were searched from their inception to November 2025. Studies were included if they involved patients of any age presenting to the ED with musculoskeletal, traumatic, vestibular conditions or concussion, where physiotherapists applied or reported at least one standardized outcome measure. Two reviewers independently screened titles, abstracts, and full texts.</p><p><strong>Results: </strong>Of 9,790 records identified, 27 met eligibility criteria. Most research originated from Australia, Canada, the United Kingdom, Ireland, and the United States, primarily involving low-complexity musculoskeletal conditions, vestibular disorders, and concussion, including pediatric pathways. Pain intensity scales (NPRS, VAS) and pain interference (BPI-PI) were the most commonly used measures. Functional and disability outcomes (NDI, ODI/mODI, LEFS, QuickDASH, PROMIS Physical Function, PSFS) were predominantly applied during post-ED follow-up. Psychological and prognostic instruments (PCS, STarT Back, 5P Rule) supported risk stratification, while PREMs such as PedsQL Healthcare Satisfaction, SAPS, and VSQ-9 assessed patient experience. Considerable heterogeneity in outcome measurement remains, with few randomized trials, limited long-term follow-up, and scarce economic evaluations. No studies were identified from Italy or Southern Europe.</p><p><strong>Conclusions: </strong>The use of validated outcome measures by physiotherapists in EDs is feasible and clinically valuable; however, a lack of standardization and limited high-quality evidence particularly within the Italian healthcare context highlight the need for further research to establish shared outcome sets and transferable models of care.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"98 5","pages":"239-252"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roma 2 Local Health Authority and Fondazione Baroni for the safety and accessibility of care: aninnovative telerehabilitation project for patients withspinal cord injuries.","authors":"Annamaria Servadio, Leandro Segaletti, Claudio Sales, Giuliana La Rocca, Maria Luisa Giordano, Claudio Pilati, Simona Amato","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 emergency has forced a rapid reorganization of healthcare services, suspending many non-urgent outpatient services and redefining the offering based on companies' potential for process and resource optimization and adapting it to the new context. In this period, therefore, it became necessary to use digital media and to verify the possibility of ensuring remote services for chronic patients. In light of this experience, ASL ROMA 2 has implemented a research project to ensure the remote rehabilitation of chronic patients with motor impairments, in particular with spinal cord injury. The project was funded by the Baroni Foundation Objectives: Since 2023, ROMA 2 local health authority (ASL ROMA 2) has launched a project for the use of a platform dedicated to telerehabilitation, funded by the Baroni Foundation, with the following objectives: Objectives: Since 2023, ROMA 2 local health authority (ASL ROMA 2) has launched a project for the use of a platform dedicated to telerehabilitation, funded by the Baroni Foundation, with the following objectives: ensure access and continuity of care, including continued rehabilitation at home. improve rehabilitation interventions through the appropriate use of remote services and capabilities; these allow for better tailoring of treatment frequency and intensity to the needs and preferences of The platform can be integrated with other healthcare systems and supports protocol and plan definition, wearable device integration, telerehabilitation, schedule management, clinical monitoring, and more. The technology architecture is based on open-source software solutions such as Kafka, Kubernetes, Java, Typescript, PostgreSQL, MongoDB, TimescaleDB, AWS, KeyCloak, Drools, DSL, Strapi, and Workflow Engine. increase the efficiency of home rehabilitation services, allowing for the provision of care to a greater number of patients requiring assistance. promote monitoring, health education, and/or the adoption of appropriate self-care practices. These objectives are consistent with the objectives outlined in the National Recovery and Resilience Plan (PNRR) Mission 6 - Health Component 1 (M6C1) Proximity networks, facilities, and telemedicine for community care. This paper describes the results of the research project \"Fleexi-Rehab-Care-Tech (FRCT)\" by ASL ROMA 2, focusing on tele-assistance and the provision of physiotherapy and occupational therapy for patients with motor and neuromotor injuries.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"98 5","pages":"331-336"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of rehabilitation timing in the care of patients with COPD: a challenge for public health.","authors":"Annamaria Servadio, Matteo Tamburlani, Tiziana Trequattrini, Simona Rossi, Anna Cerrito, Cosetta Donato, Mariarita Loporchio, Laura Sanrocchi, Cristian Mendico, Giovanni Galeoto, Maria Cristina Zappa","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The management of chronic and multiple chronic conditions is a major challenge for public health. The pilot study aims to develop a mathematical model which, together with a telemonitoring protocol, will ensure the reprogramming of chronic patients in the medium to long term, optimizing waiting lists and, consequently, the quality of the service provided, including through the pursuit of equity and accessibility to the service.</p><p><strong>Materials and methods: </strong>The study was conducted by the clinical rehabilitation team at the San Felice Polyclinic of ASL Roma 2 between September 2024 and April 2025. Fifty-four patients diagnosed with moderate COPD were recruited and treated, divided into three groups of 18, and were re-evaluated 3, 4 and 5 months after discharge. The patients underwent 20 group respiratory rehabilitation sessions and aerobic training with progressive load on exercise bikes.</p><p><strong>Statistical analysis: </strong>For each sample of patients, the mean and standard deviation were calculated of the STS and 6MWT recorded at the beginning of treatment (T0) and at the end (T1) of this, at the beginning of the second cycle after the established period (T2) and at the end of the same (T3). To evaluate the effectiveness of treatment with readmission at 3, 4 and 5 months, the average of the test values at the end of the first cycle and at the beginning of the second cycle was considered; the Wilcoxon-Mann-Whitney hypothesis test was used to compare the distributions.</p><p><strong>Results: </strong>For each of the tests carried out both at admission and discharge, the left extreme and right extreme are lower than those of the other groups. The Wilcoxon-Mann-Whitney hypothesis test shows that the treatment is more effective when carried out 3 or 4 months after the last treatment than when carried out 5 months after the last treatment.</p><p><strong>Discussion: </strong>The study revealed the importance of initiating comprehensive and individualised pulmonary rehabilitation protocols to reduce the incidence of exacerbations, thus also producing economic and health benefits. Statistical analysis confirmed a shared approach to planning long-term readmissions, thus facilitating the management of waiting lists and the staff involved, improving the quality of the service in terms of efficiency and productivity.</p><p><strong>Conclusion: </strong>In a period of severe crisis for the Regional Health Service, the management of waiting lists ensures the constant pursuit of equitable access to care and accessibility to the service, understood as the ability of a service or environment to be usable without barriers for everyone and to reach the highest number of users with COPD. Telerehabilitation and telemonitoring could represent a great opportunity that can increase the level of enforceability of citizens' right to health, sustainability and innovation of the National Health System.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"98 5","pages":"261-272"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Error Room as an andragogical methodology for Patient Safety. An Italian experience.","authors":"Simona Amato, Cristina De Capitani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Simulation courses develop both technical and non-technical skills. The latter are the most important skills for preventing errors resulting from communication or awareness. The error room methodology involves setting up spaces that match the work environments of the professionals being trained, within which training programs are offered that adhere to the most effective andragogical techniques. This training project involved 280 nurses with an average age of 39.7 years. A total of 1,560 hours of simulation training were provided in the error room. This paper demonstrated that the Error Room certainly represents an opportunity for technical and non-technical skills, but above all, it allows multidisciplinary teams to practice innovative organizational models together.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"98 5","pages":"337-339"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternity and Critical Care: A Qualitative Survey of the Experience of Nurse Mothers.","authors":"Anna Arnone, Francesco Riccardo, Giovanni Gioiello, Alessandro Marino, Luisa Zeppetella","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Returning to work after maternity leave is a critical transition for nurses, especially in critical care units, where intense workloads and clinical responsibilities may conflict with family needs.</p><p><strong>Aim: </strong>To explore and understand the meaning of the lived experiences of nurse mothers returning to critical care work in the Italian context.</p><p><strong>Methods: </strong>Qualitative study using an interpretative phenomenological approach. Snowball sampling; 12 nurse mothers with at least one year of post-partum work were interviewed through semi-structured interviews (45-60 minutes). Data were manually analyzed using thematic analysis (Braun & Clarke, 2006), with researcher triangulation and member checking. Informed consent was obtained.</p><p><strong>Results: </strong>Four main themes emerged: work-family conflict; informal vs. organizational support; redefinition of professional identity; coping strategies. Nurses reported emotional strain, lack of institutional support, and reliance on personal coping mechanisms.</p><p><strong>Conclusions: </strong>Nurse mothers in critical care face both vulnerability and resilience. Inclusive organizational policies and structured return-to-work programs are urgently needed.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"98 5","pages":"253-260"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Oral Diseases and Assessment of Quality of Life in Geriatric patients with and without comorbidities - A Systematic Review.","authors":"Karthik Shunmugavelu, Evangeline Cynthia Dhinakaran","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The global rise in the ageing population has increased the burden of chronic oral diseases among older adults, particularly in regions with limited geriatric-focused healthcare resources. Age-related physiological decline, multimorbidity, and polypharmacy collectively heightened susceptibility to dental caries, periodontal disease, tooth loss, xerostomia, and prosthetic complications. Despite this growing concern, evidence on how comorbidities influence oral health and quality of life among geriatric individuals remained fragmented.</p><p><strong>Aim: </strong>This systematic review aimed to determine the prevalence of oral diseases among geriatric adults and to assess oral health-related quality of life (OHRQoL), while examining the impact of comorbidities, multimorbidity, and polypharmacy.</p><p><strong>Materials and methods: </strong>The review was conducted according to PRISMA 2020 guidelines and was prospectively registered in PROSPERO [CRD420251232457]. A comprehensive search of PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar was performed for studies published from January 2000 up to date. Observational studies involving adults aged ≥60 years that reported oral health indicators and OHRQoL using validated instruments (GOHAI, OHIP) were included. Data extraction and quality appraisal were carried out independently by two reviewers using the Joanna Briggs Institute (JBI) checklist. Due to heterogeneity across populations and assessment tools, a narrative synthesis was employed.</p><p><strong>Results: </strong>Five studies met the eligibility criteria, representing institutionalized Italian elders, tribal elders in Kerala and Tamil Nadu, dental outpatients in Delhi, and community-dwelling older adults in Iran. Across all settings, high levels of dental caries, periodontal destruction, tooth loss, and inadequate prosthetic rehabilitation were observed. OHRQoL was consistently reduced, with the poorest scores among individuals with multimorbidity and functional impairment. Comorbidities and polypharmacy showed strong associations with compromised oral health and diminished OHRQoL.</p><p><strong>Conclusion: </strong>Oral diseases remained a major public-health concern among geriatric adults. The strong influence of comorbidities, multimorbidity, and polypharmacy on oral health underscored the need for integrating oral healthcare into routine geriatric services. Targeted preventive strategies, improved accessibility, and interdisciplinary care approaches are essential to enhance functional well-being and quality of life in ageing populations.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"98 5","pages":"285-300"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Artificial Intelligence in cardiology - A systematic review.","authors":"Harepriya Meganathan Karthikeyini, Marian Barsoum, Tharun Venkatesan, Mani Shankar Reddy Challa","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is increasingly applied in cardiology to enhance diagnostics, risk prediction, remote monitoring, and patient management. With the proliferation of wearable devices and advanced imaging technologies, AI promises to improve cardiovascular outcomes and healthcare efficiency.</p><p><strong>Objective: </strong>This systematic review evaluates recent evidence on AI applications in cardiology, focusing on diagnostic accuracy, wearable and remote monitoring technologies, image interpretation, and clinical utility.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across PubMed, Scopus, IEEE Xplore, Web of Science, and Google Scholar for studies published up to September 2025. Eligible studies included original research on AI-driven diagnostics, wearable-based monitoring, and imaging interpretation in cardiovascular medicine. Data extraction included study design, AI methodology, population, outcomes, and key findings. Quality assessment was performed using QUADAS-2 and NIH tools, and findings were synthesized narratively and comparatively.</p><p><strong>Results: </strong>AI applications demonstrated high diagnostic performance across modalities. Wearable and edge-computing devices enabled real-time ECG analysis, arrhythmia detection, and heart failure monitoring with high accuracy, precision, and responsiveness. AR-assisted stethoscopes improved auscultation accessibility and diagnostic confidence. AI-driven quantitative coronary CT outperformed myocardial perfusion imaging in detecting obstructive coronary artery disease. Pediatric cardiology AI models exhibited limited accuracy, highlighting the need for further refinement. Overall, AI integration in cardiology shows potential for enhancing early detection, personalized management, and preventive care, though challenges such as data integration, validation, regulatory approval, and clinical adoption remain.</p><p><strong>Conclusion: </strong>AI technologies are transforming cardiology by enabling precise diagnostics, remote monitoring, and predictive analytics. Ongoing validation, standardization, and interdisciplinary collaboration are essential to ensure safe, effective, and clinically impactful implementation.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"98 5","pages":"273-284"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improve the quality of patient care in the Emergency Department. Physical Therapist and Advanced Practice in Emergency Department: A scoping review.","authors":"Annamaria Servadio, Maria Rita Molinari, Loredana Gigli, Emanuele Amadio, Giovanni Sellitto, Giovanni Galeoto","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Emergency departments (EDs) worldwide are increasingly adopting multidisciplinary models of care in which physiotherapists play an evolving and expanding role. International evidence suggests that physiotherapy-led pathways may improve the management of low-acuity presentations such as musculoskeletal and vestibular conditions, which contribute substantially to ED overcrowding. In Italy, however, physiotherapists are not yet structurally integrated into ED teams, and the potential applicability of advanced physiotherapy roles remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The objective of this scoping review is to identify, map, and describe current international models of physiotherapy practice within Emergency Departments, including first-contact roles, advanced practice, direct-access models, and multidisciplinary roles, and to explore their impact on the management of non-urgent conditions such as minor injuries, musculoskeletal disorders, and vestibular presentations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). A systematic search of PubMed and Google Scholar was conducted from inception to November 2025, including peer-reviewed studies in English that described, evaluated, or implemented physiotherapy roles in EDs. Eligible populations were ED patients of any age presenting with non-urgent musculoskeletal, traumatic, or vestibular conditions. Data were charted on study design, setting, models of practice, clinical populations, and reported outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The included studies were primarily conducted in Australia, Canada, and the United Kingdom, and comprised service evaluations, retrospective reviews, quality-of-care studies, pilot projects, validation studies of screening tools, and mixed-methods evaluations of pediatric pathways. Physiotherapy practice in Emergency Departments is mainly organized into First Contact Physiotherapy, Advanced Practice, and Direct Access models, often embedded within specialized pathways for musculoskeletal, vestibular, pediatric, or geriatric care. Overall, physiotherapist-led care is associated with reduced waiting times and ED length of stay, earlier administration of analgesia, improved clinical outcomes (including reduced pain and improved vestibular symptoms), high diagnostic agreement with emergency physicians, lower use of imaging and follow-up services, and high satisfaction among patients, parents, and clinicians. No serious adverse events related to physiotherapy interventions were reported. Most studies were observational, with a limited number of randomized or controlled studies, and no studies were conducted in Italy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;International evidence indicates that physiotherapists can make a meaningful contribution to emergency department care, particularly for low-acuity musculoskeleta","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"98 5","pages":"301-330"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Exclusion of the self from the self care in a today of gaps: reflections and recommendations.","authors":"Miguel Angel Cardozo-Montilla","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dear Editor, In a world which the disparities in access to health services are not problems that only concern minorities, vulnerable populations and societies with the lowest levels of development, the self care is an issue that transcends all borders and, therefore, constitutes together with others strategies the core of the global priorities, a need that, for instance, intersects the set of targets of the third goal of the 2030 agenda for sustainable development¹ within which the progress both in reducing maternal mortality across the world, that went from 228 to 197 deaths per 100 000 live births between 2015 and 2023, and in achieving universal health coverage has been exiguous².</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"98 5","pages":"236-238"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}