Emanuela Nuccio

Background/Objectives: Early defibrillation is critical for survival after out-of-hospital cardiac arrest (OHCA), yet delays arise from interacting community, organizational, dispatch, and emergency medical services (EMS) factors. This scoping review mapped determinants of delayed defibrillation, examined temporal measurement approaches, and summarized associations with clinical outcomes. Methods: A preregistered scoping review was conducted following Joanna Briggs Institute guidance and PRISMA-ScR reporting standards. PubMed/MEDLINE, Scopus, and CINAHL were searched in February 2026. Two reviewers independently screened records, and extracted data were cross-checked. Evidence was synthesized descriptively across system-level domains and temporal categories. Results: Of 4456 records identified, 82 studies were included, predominantly observational (75/82, 91.5%). Determinants were classified as community-related (32/82, 39.0%), system-related (26/82, 31.7%), dispatch-related (18/82, 22.0%), and EMS-related (6/82, 7.3%). Fifty-two studies reported classifiable temporal metrics. Among 48 studies linking timing or early-defibrillation determinants with outcomes, 31 examined direct or multiple shock-related intervals, two examined upstream operational response times, and 15 used indirect indicators. Of the 31 studies assessing direct or multiple shock-related intervals, 30 (96.8%) indicated more favorable outcomes with shorter timing. All 28 studies using a single direct shock-related interval showed directional concordance. Conclusion. Defibrillation delays reflect interconnected system-level processes rather than EMS response time alone. Standardized temporal measurement, integrated AED and responder networks, and targeted strategies addressing geographic and socioeconomic disparities may support earlier defibrillation. These findings have implications for emergency-care organization, interprofessional coordination, and nursing education in resuscitation systems.

Background: Nurse burnout is a major occupational health problem with implications for workforce retention, quality of care, and patient safety. Contemporary evidence consistently links burnout to increased missed care, adverse events, and reduced safety climate, underscoring the need for updated national data and identification of modifiable organizational factors. Objective: To describe burnout levels among Italian nurses using the Copenhagen Burnout Inventory (CBI) and to examine associations between burnout, job satisfaction, weekly working hours, and key sociodemographic and professional characteristics. Methods: We conducted a national, observational cross-sectional online survey (Google Forms) between April and May 2026. Convenience and snowball sampling were used via professional social media channels and nursing-related institutional pages. Burnout was measured using the Copenhagen Burnout Inventory (CBI; 19 items covering personal, work-related, and patient-related burnout). Responses were converted to standardized 0–100 scores (higher scores = higher burnout); total burnout was computed as the mean of the three subscales. Job satisfaction was assessed on a 1–5 Likert scale. Group comparisons used Mann–Whitney U and Kruskal–Wallis tests; associations used Spearman’s rho; multivariable linear regression was fitted to examine factors independently associated with burnout. Results: The sample included 557 nurses; 84.6% were women, 37.0% were aged p < 0.001) and negatively with job satisfaction (ρ = −0.620, p < 0.001). In multivariable models, higher job satisfaction remained the strongest independent factor associated with lower burnout, while working >40 h/week remained independently associated with higher burnout. Conclusions: Burnout among Italian nurses was prevalent at moderate-to-high levels. Job satisfaction emerged as the main organizational factor associated with burnout, while higher workload was also significantly associated with greater burnout levels. These findings highlight the importance of organizational strategies addressing working conditions to support nurse well-being and patient safety.

Background/Objective: Health is a multidimensional construct shaped not only by clinical conditions but also by psychological, social, environmental and cultural factors. In low- and middle-income countries undergoing rapid epidemiological transition, understanding health requires integrated and culturally informed approaches. However, quality of life, perceived health status and lifestyle behaviors are often investigated separately, limiting the interpretation of well-being in specific local contexts. This study aimed to provide an integrated assessment of quality of life, perceived health status and lifestyle behaviours among adults attending a peri-urban public hospital in Kenya, using internationally validated instruments applied within a specific local cultural context. Methods: A cross-sectional observational study was conducted at Tigoni Level 4 Hospital, Kiambu County, Kenya. Adult outpatients (N = 40) were consecutively recruited. Quality of life was assessed using the WHOQOL-BREF, perceived health status using the EQ-5D-5L and EQ-VAS, and lifestyle behaviours using selected modules of the WHO STEPS instrument. Descriptive statistics were performed, and exploratory associations were examined using Spearman’s rank correlation coefficient. Results: Participants had a mean age of 35.9 ± 11.4 years, with a balanced gender distribution. Lifestyle risk factors were prevalent, including insufficient physical activity (40%) and overweight or obesity (>50%). WHOQOL-BREF scores revealed a heterogeneous profile, with relatively preserved social relationships and lower scores in the psychological and environmental domains. Pain/discomfort and anxiety/depression were the most frequently reported EQ-5D-5L problems. The mean EQ-VAS score was 68.2 ± 15.7. Perceived health was positively associated with physical and psychological quality of life, while higher body mass index was associated with lower physical quality of life. Mental health emerged as a cross-cutting factor across instruments. Conclusions: The findings highlight the multidimensional nature of health in a peri-urban Kenyan context and suggest the importance of considering local social and cultural influences when interpreting standardized health measures. Mental health and environmental conditions play a central role in shaping quality of life and perceived health, while lifestyle risk factors are already prevalent in a relatively young outpatient population. Integrating standardized health measures within a cross-cultural framework may support more holistic and person-centred approaches in primary care and public health in similar settings.

Non-small-cell lung cancer (NSCLC) remains the leading cause of cancer-related deaths worldwide with only approximately 30% of new diagnoses manifesting with localized stages IA–IIA. Osimertinib is a third-generation inhibitor of the epidermal growth factor receptor (EGFR), which is used for treating metastatic, locally advanced, and early-stage NSCLC expressing common EGFR mutations. Two phase III clinical trials supported yresectable locally advanced disease, consisting of the ADAURA and LAURA studies, respectively. On the other hand, conflicting data on neoadjuvant efficacy led to the design of the ongoing Neo-ADAURA trial. In this review, we describe the pivotal trials that led to the approval of osimertinib use as an adjuvant treatment in radically resected NSCLC patients and as maintenance therapy after chemoradiotherapy. We also summarize the principal ongoing clinical trials in the neoadjuvant and adjuvant settings. Finally, we analyze several issues about the use of osimertinib in those different early settings while also depicting future perspectives and the potential evolution of treatment strategies.