Objective: Apical periodontitis (AP) is one of the most common pathologies of the oral cavity. An early and accurate diagnosis of AP lesions is crucial for proper management and planning of endodontic treatments. This study investigated the diagnostic accuracy of periapical radiography (PR) and panoramic radiography (PAN) in the detection of clinically/surgically/histopathologically confirmed AP lesions. Method: A systematic literature review was conducted in accordance with the PRISMA guidelines. The search strategy was limited to English language articles via PubMed, Embase and Web of Science databases up to June 30, 2023. Such articles provided diagnostic accuracy values of PR and/or PAN in the detection of AP lesions or alternatively data needed to calculate them. Results: Twelve studies met inclusion criteria and were considered for the analysis. The average value of diagnostic accuracy in assessing AP lesions was 71% for PR and 66% for PAN. According to different accuracy for specific anatomical areas, it is recommended to use PR in the analysis of AP lesions located in the upper arch and lower incisor area, whereas lower premolar and molar areas may be investigated with the same accuracy with PR or PAN. Conclusions: Two-dimensional imaging must be considered the first-level examination for the diagnosis of AP lesions. PR had an overall slightly higher diagnostic accuracy than PAN. Evidence from this review provided a useful tool to support radiologists and dentists in their decision-making when inflammatory periapical bone lesions are suspected to achieve the best clinical outcome for patients, improving the quality of clinical practice.

Introduction: Globally the ongoing reforms of the national healthcare systems are carrying out social and health services closer to users, increasingly reaching them at home. This approach addresses the challenges posed by population aging, chronic diseases, and social inequalities. Effective solutions require combining experience, expertise, and resources within a unified organizational model for the social and health care services provision. This is particularly crucial for providing integrated care to frail individuals aged 65 or over. This article aims to explore service innovations for frail population aged 65 years or older, focusing on the integrated management of economic and professional resources in health and social services to ensure continuity of care.Method: The Agency of Integration for Continuity between Hospital and Territory (AgICOT), a service financed by the Italian Ministry of Health designed for frail individuals aged 65 or over in Local Health Authority of Teramo (Abruzzo, Italy) was selected as case study.Results: AgICOT utilized health plans and health budgets to integrate social and health goals and resources into a single social and health care pathway, avoiding duplication of interventions, saving resources, and ensuring economic sustainability of social and healthcare systems.Discussion: AgICOT has demonstrated its effectiveness as organizational response to the complex needs of frail individuals aged 65 or over, ensuring high-quality social and healthcare services in a sustainable manner.Final considerations: The co-responsibility of various stakeholders has been the key to the success of this project, creating the conditions for transitioning from hospital-based to person-based social and healthcare in line with international recommendations on integrated care and continuity of care.

Introduction: In 2021, the National Recovery and Resilience Plan (PNRR) outlined the foundational pillars for Italy’s economic recovery following the COVID-19 pandemic. Within PNRR’s Mission 6 “Health”, guidelines were established to reform the Italian healthcare system, focusing on community-based services and digitalization. This ambitious reform aims to shift from a hospital-centred model to a patient-centred one that promotes integrated provision of social and healthcare services.Methods: The lack of institutional working groups to incorporate input from all Italian recognized healthcare professionals into PNRR’s implementation, the National Federation of Orders of Radiographers and Technical, Rehabilitative, and Prevention Health Professionals (FNO TSRM & PSTRP) addressed this gap by initiating a study.Results: The contributions from the 19 Italian Allied Health Professionals (AHPs) affiliated with the FNO TSRM & PSTRP were collected to identify priority areas and formulate actionable recommendations aimed at enhancing the organizational model of reformed Italian healthcare system outlined by the PNRR, which had been predominantly focused on nursing care.Discussion: Adopting a multi-professional and multidisciplinary approach could better address social and health needs of the population by leveraging the expertise of all registered Italian health professionals. This approach aligns Italian healthcare system with European standards, addressing issues such as task shifting and shortages in professional resources. Ultimately, this study provides concrete insights for Italian policymakers and healthcare leaders to foster greater inclusion of Italian AHPs in the design and implementation of the current and future reforms on national healthcare system.

Introduction: The World Health Organization (WHO) has recognized art therapy as an effective supportive mechanism for the maintenance and restoration of mental health. In recent years, art therapy has been integrated in the assistance pathways of older people affected by neurocognitive disorders according to the demonstrated benefits, as no conflicts with pharmacologic treatments and the reduction of anxiety and stress. The shortage of organizational, economic, and professional resources in social-health public organizations does not allow for guaranteeing the provision of these services without the help of the private ones, not exclusively belonging to social-health sector. This research aims to investigate how the collaboration between public and private organizations of different sectors in the co-provision of non-pharmacological approaches guarantees the economic sustainability and the quality improvement of the provided services.Methods: The Alzheimer Café of Prato was selected as a significant case study.Results and Discussion: Art therapy programs intended for taking care of older people in the first stages of the Alzheimer’s disease have been developed, planned, supplied, and managed over the years as a result of the integration of resources, ideas, and professionals provided both by public and private sectors, the social-health sector, and cultural organizations.Conclusions: The peer-to-peer co-responsibility of all organizations (public and private, from the cultural sector as well as the social and health sector) involved in the co-design of art therapy programs, not limiting their actions to only co-financing and/or co-delivery of the service, enabled the achievement of the economic sustainability of the services and the improvement of their quality.

The lack of resources has driven healthcare management studies to recognise Private and Public Partnerships (PPP) as the solution in managing efficiency, effectiveness and profitability of technological innovation. Recent researchers have identified the buying model called Managed Equipment Service (MES), in which purchaser and seller share the risks of technology’s management and use, as an optimal problem-solving method. The aim of this research is to analyse the potential economic-financial and organizational benefits of MES introduction in healthcare, in particular for the acquisition of the diagnostic imaging technologies. The research applies the case study method. We have examined a representative Italian Local Health Authority for its dimensions, managerial characteristics and case-mix offered but, especially, for its high health standards. In the study we have involved the strategic figure of radiographer in diagnostic imaging. The data has been elaborated through statistical analysis to observe the correlations. Evidence demonstrates that MES costs are lower than all the other planning and purchasing methods analysed (between 11% - 239%). When correlations between age of facilities and effectiveness of provided services is strong, MES grants the maintenance of a lower average age of technologies and a more efficient use of resources and significant margins of profitability. The emerging model of PPP is a possible solution to the current issues surrounding economic and financial sustainability of healthcare systems, considered the fewer resources and the technological progress. MES in healthcare appears to be a highly efficient way of managing innovation, in particular for diagnostic imaging technologies. Keywords: Public Private Partnership (PPP), Managed Equipment Service (MES), middle-high technologies, diagnostic imaging.