Background/Objectives: Human papillomavirus (HPV) is a leading cause of cervical cancer. Despite the proven effectiveness of vaccination programs, global coverage remains uneven, with significant disparities across regions due to various socioeconomic, cultural, and political factors. This study explores the primary barriers to HPV vaccination worldwide and proposes recommendations to improve access to screening and vaccination programs. Methods: A systematic literature review was conducted, analyzing studies published in the past ten years from databases such as PubMed, Scopus, and Embase, following the PRISMA methodology. Study selection involved multiple researchers, with discrepancies resolved through consultation. The quality of the included studies was assessed using CASP checklists. The protocol was registered on Open Science Framework (OSF). Results: Out of 2119 records, eight studies were included. The findings indicate that the main barriers to HPV vaccination include insufficient public awareness, cultural and religious resistance, financial constraints, and limited access in rural and underserved areas. Additionally, political factors, such as low prioritization of HPV vaccination and the absence of supportive policies, were identified as significant obstacles. Multidisciplinary and cross-cultural collaboration, along with the integration of HPV vaccination into existing health programs, was suggested as a strategic approach to improve vaccine uptake. Conclusions: Barriers to HPV vaccination, including limited awareness, inadequate healthcare infrastructure, and socioeconomic factors, vary across regions but must be addressed to improve global coverage. Targeted interventions such as health education, inclusive policies, and culturally sensitive campaigns can significantly boost vaccine uptake. Strengthening local health systems and fostering international collaboration are key strategies to overcoming these barriers and ensuring equitable access to HPV vaccination.

Caregiver characteristics and behaviours are associated with patients’ and caregivers’ outcomes. However, there is scarce evidence on interventions aimed at improving caregiver contribution (CC) to patient self-care, caregiver self-efficacy, and caregiver preparedness in heart failure (HF). This study aims to evaluate the effect of Motivational Interviewing (MI) on CC to patient self-care, caregiver self-efficacy, and caregiver preparedness in HF. This is a secondary outcome analysis of MOTIVATE-HF randomized controlled trial. Caregivers of patients with HF were randomized into three arms: Arm 1 (MI for patients), Arm 2 (MI for patients and caregivers), and Arm 3 (standard care). The intervention consisted of one MI session plus three telephone contacts. Data were collected at baseline and after 3, 6, 9, and 12 months. A total of 510 patient and caregiver (median age 54 years, 76% females) dyads were enrolled, 235 caregivers and 238 patients completed the study until 12 months. Caregiver contribution to self-care maintenance and management and caregiver preparedness significantly improved over time, but without significant differences among the three arms. At 9 months, caregiver self-efficacy improved more in Arm 2 than Arm 3 [difference: 8.36, 95% confidence interval (CI) (3.13; 13.59), P = 0.001]. This improvement remained significant also at linear mixed model [ $β^$ = 1.39, 95% CI (0.02; 2.75), P = 0.046]. Motivational Interviewing did not improve CC to patient self-care and caregiver preparedness. However, it increased caregiver self-efficacy, which is known to be a powerful mediator of CC to self-care. Clinicaltrials.gov: NCT02894502.

Aims Intense health-care service use and high mortality are common in heart failure (HF) patients. This secondary analysis of the MOTIVATE-HF trial investigates the effectiveness of motivational interviewing (MI) in reducing health-care service use (e.g. emergency service use and hospitalizations) and all-cause mortality. Methods and results This study used a randomized controlled trial. Patients and caregivers were randomized to Arm 1 (MI for patients), Arm 2 (MI for patients and caregivers), or Arm 3 (control group). Data were collected at baseline and at 3, 6, 9, and 12 months. Face-to-face MI plus three telephone calls were performed in Arms 1 and 2. The sample consisted of 510 patient (median age 74 years, 58% male patients) and caregiver dyads (median age 55 years, 75% female patients). At 12 months, 16.1%, 17%, and 11.2% of patients used health-care services at least once in Arms 1, 2, and 3, respectively, without significant difference. At 3 months, 1.9%, 0.6%, and 5.1% of patients died in Arms 1, 2, and 3, respectively. Mortality was lower in Arm 2 vs. Arm 3 at 3 months [hazard ratio (HR) = 0.112, 95% CI: 0.014–0.882, P = 0.04]; no difference was found at subsequent follow-ups. Mortality was lower in Arm 1 vs. Arm 3 at 3 months but did not reach statistical significance (HR = 0.38, 95% CI: 0.104–1.414, P = 0.15). Conclusion This study suggests that MI reduces mortality in patients with HF if caregivers are included in the intervention. Further studies with a stronger intervention and longer follow-up are needed to clarify the benefits of MI on health-care service use and mortality.

Background: Diabetes affects over 460 million people worldwide and represents a growing public health challenge driven largely by dietary and lifestyle factors. While Type 2 diabetes (T2D) is more prevalent, Type 1 diabetes (T1D) presents unique therapeutic challenges, particularly in younger individuals. Advances in diabetes management, such as continuous glucose monitoring (CGM), insulin pumps (IP), and, more recently, smart multiple dose injection (MDI) pens, have significantly enhanced glycemic control and improved patients’ quality of life. Aim: This study aims to evaluate the baseline characteristics of patients switching from MDI therapy to the Medtronic Smart MDI system [composed of a smart insulin pen (InPenTM) and a connected CGM Medtronic SimpleraTM sensor] and to assess its impact on glycemic outcomes over different time periods (14, 30, and 90 days). Methods: A retrospective observational study was conducted among adults with T1D who initiated Medtronic Smart MDI therapy. Participants were enrolled voluntarily at the Diabetes and Nutrition Clinic in Ast Fermo, Marche Region, Italy. Glycemic parameters were monitored using CGM data and analyzed with descriptive statistics, including mean, standard deviation (SD), and interquartile range (IQR). Comparisons across time periods were performed using the Wilcoxon signed-rank test, with statistical significance set at p < 0.05. Results: This study included 21 participants with a mean age of 51.5 years, a mean BMI of 24.7, and a mean duration of T1D of 21.9 years. The transition from a traditional MDI system to the Smart MDI system resulted in significant improvements in key glycemic parameters: mean Sensor Glucose (SG) decreased from 171.0 mg/dL to 153.5 mg/dL (p = 0.035), Time In Range (TIR) increased from 58.0% to 64.4% (p = 0.005), and time above range (TAR; >180 mg/dL) decreased from 39.0% to 34.2% (p = 0.015). No significant differences were observed in the time below range (TBR). Conclusions: The transition to the Medtronic Smart MDI system significantly enhanced glycemic control by lowering mean glucose levels and increasing TIR. These findings highlight its efficacy in improving hyperglycemia management while maintaining a stable risk of hypoglycemia.

Background and Objectives: Diabetes is a global public health challenge, with increasing prevalence worldwide. The implementation of artificial intelligence (AI) in the management of this condition offers potential benefits in improving healthcare outcomes. This study primarily investigates the barriers and facilitators perceived by healthcare professionals in the adoption of AI. Secondarily, by analyzing both quantitative and qualitative data collected, it aims to support the potential development of AI-based programs for diabetes management, with particular focus on a possible bottom-up approach. Materials and Methods: A scoping review was conducted following PRISMA-ScR guidelines for reporting and registered in the Open Science Framework (OSF) database. The study selection process was conducted in two phases—title/abstract screening and full-text review—independently by three researchers, with a fourth resolving conflicts. Data were extracted and assessed using Joanna Briggs Institute (JBI) tools. The included studies were synthesized narratively, combining both quantitative and qualitative analyses to ensure methodological rigor and contextual depth. Results: The adoption of AI tools in diabetes management is influenced by several barriers, including perceived unsatisfactory clinical performance, high costs, issues related to data security and decision-making transparency, as well as limited training among healthcare workers. Key facilitators include improved clinical efficiency, ease of use, time-saving, and organizational support, which contribute to broader acceptance of the technology. Conclusions: The active and continuous involvement of healthcare workers represents a valuable opportunity to develop more effective, reliable, and well-integrated AI solutions in clinical practice. Our findings emphasize the importance of a bottom-up approach and highlight how adequate training and organizational support can help overcome existing barriers, promoting sustainable and equitable innovation aligned with public health priorities.

Introduction: Pressure ulcers (PUs) represent a significant challenge in chronic care, particularly among the elderly with reduced mobility. They result in substantial socio-healthcare costs and negatively impact patients’ psychological well-being. Malnutrition is a key risk factor, hindering healing and increasing the risk of complications. As such, appropriate nutritional interventions are crucial for managing PUs. However, these interventions are often underestimated in clinical practice, underscoring the need for a more comprehensive approach to elder care and healthy aging. Objectives: The primary objective of this study was to identify the best scientific evidence on nutritional interventions implemented by nurses in community settings to prevent complications related to PUs. Additionally, qualitative and quantitative outcomes reported in the included studies were analyzed. Method: This systematic review was conducted following PRISMA international guidelines. Searches were performed in PubMed, Scopus, Embase, and CINAHL databases. A predefined search strategy using Boolean operators was employed, and two researchers independently selected papers, with a third researcher resolving any discrepancies. Additional sources and manual reviews were conducted to minimize selection bias. Results: Out of 1003 records, 6 studies were included. Findings indicate that nurses play a fundamental role in managing PUs in community settings through specific nutritional intervention assistance processes. These healthcare professionals are pivotal in the prevention, care, and rehabilitation of vulnerable individuals with PUs. Conclusions: Nurses are strategic in the management of PUs within community care for frail populations. With nutritional support that plays a key role in both preventing and accelerating the healing of PUs. Policymakers are encouraged to invest in nursing roles to enhance assistance in community contexts, supporting healthy aging and lifestyle medicine approaches.