Search Results (7,922)

Background: A functional balance between angiotensin II receptors (AT1R/AT2R) is associated with the regulation of cardiovascular, inflammatory, and tissue remodeling processes. Interventions that promote this balance have a significant impact on quality of life. Physical exercise stands out among these interventions, as the literature extensively identifies it as a therapeutic tool for managing conditions linked to the main axis of the renin–angiotensin system (RAS). Despite its beneficial role regarding the RAS, its effects on AT1R and AT2R receptor expression have not yet been systematically synthesized. Objective: To review the literature and systematically compile existing knowledge regarding the effect of physical exercise on the expression of angiotensin II receptors (AT1R and AT2R) within the RAS. Methods: This is a systematic review registered in PROSPERO (CRD420251267388). Searches were conducted in the PubMed/MEDLINE, PEDro, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, Latin American and Caribbean Health Sciences Literature (LILACS), Web of Science, and Scopus databases. Risk of bias was assessed using the RoB 2 and SYRCLE tools. A total of 724 studies were identified, of which 11 met the eligibility criteria: 10 conducted using experimental animal models and 1 involving humans. Results: Eleven studies were included, predominantly animal experimental models. The findings indicate that chronic cyclic physical exercise is associated with reduced AT1R expression and increased AT2R expression in different tissues. In contrast, the only study that evaluated resistance exercise showed a distinct physiological response, with increased AT1R expression. Conclusions: The results suggest that chronic cyclical physical exercise promotes an increase in AT2R receptor expression and a reduction in AT1R expression in various body tissues, although the evidence is derived primarily from animal studies. Full article

Background/Objectives: Hypercapnic respiratory failure (HRF) is a serious complication of chronic obstructive pulmonary disease (COPD) and is associated with increased morbidity, mortality, and healthcare utilisation. National HRF trends among patients with COPD remain poorly characterised in Lithuania, and the knowledge of prehospital emergency-care professionals regarding oxygen therapy and hypercapnia has not been evaluated. Methods: This study comprised two components. First, a cross-sectional online survey assessed knowledge of COPD, hypercapnia, and oxygen therapy among prehospital emergency-care professionals (EMS physicians, emergency nurses, EMS paramedics, and paramedics); three questionnaire items whose designated correct answers could not be unambiguously supported were excluded from the knowledge score, and the original 10-item score was retained as a sensitivity analysis. Second, nationwide electronic health record data from the Lithuanian national health record system (ESPBI IS, 2020–2023) were analysed retrospectively: patients with COPD and concomitant chronic HRF were identified using ICD-10-AM diagnostic codes, and the number of patients with a recorded J96.11 diagnosis irrespective of underlying disease was obtained as a national denominator. Proportions are reported with 95% confidence intervals and temporal trends as absolute changes in percentage points; multivariable logistic regression was used to estimate odds ratios adjusted for age group and sex. Between-year differences were tested using the χ² test with Holm-adjusted pairwise comparisons, and the association between sex and chronic HRF was expressed as an odds ratio. All tests were two-sided, and p < 0.05 was considered significant. Results: Among the 65 prehospital emergency-care professionals surveyed, knowledge of hypercapnia was relatively high: 78.5% (95% CI 67.0–86.7) correctly defined it and 72.3% (95% CI 60.4–81.7) identified its symptoms, whereas 58.5% (95% CI 46.3–69.6) identified the recommended SpO₂ target range of 88–92%. Respondents answered a median of 5 of the 7 scored knowledge items correctly (IQR 4–6). Total knowledge scores differed by professional role (p = 0.034) but not by years of experience, sex, or frequency of COPD contact; the sensitivity analysis using the original 10-item score gave the same pattern (p = 0.006). In the national electronic health record data, the COPD population increased from 27,239 to 32,446 (+19.1%) between 2020 and 2023, while the number of COPD patients with a recorded chronic HRF diagnosis rose from 160 to 291 (+81.9%). The proportion rose from 0.59% (95% CI 0.50–0.69) to 0.90% (95% CI 0.80–1.01), an absolute increase of 0.31 percentage points (95% CI 0.17–0.45; risk ratio 1.53, 95% CI 1.26–1.85). Men had higher odds than women after adjustment for age (adjusted OR 1.55, 95% CI 1.28–1.88), and adjusted odds were lowest in patients aged 80 years or older. Across the four annual cross-sections, COPD accounted for 41.5% of patient-year observations with a recorded J96.11 diagnosis nationally. Conclusions: Knowledge of COPD, hypercapnia, and oxygen therapy varied among the prehospital emergency-care professionals surveyed, with one of the lowest proportions of correct responses observed for the recommended target oxygen saturation range. National electronic health record data showed an increase in the proportion of patients with COPD who had a recorded diagnosis of chronic HRF between 2020 and 2023. These components were analysed independently, and no relationship between professional knowledge and temporal trends in recorded diagnoses was assessed. The electronic health record findings support continued monitoring and recognition of chronic HRF in COPD, whereas the survey findings support further evaluation of targeted education on oxygen therapy in the prehospital setting. Full article

Background: The COVID-19 pandemic and related public-health measures, including physical distancing and the use of personal protective equipment (PPE), disrupted routine healthcare communication and care delivery for older adults with combined hearing and vision loss, or dual sensory loss (DSL). Around 1.1 million older Canadians are living with DSL and rely on multimodal communication to support assessment and continuity of care. Objectives: This study explored healthcare professionals’ (HCPs) perspectives on older adults with DSL accessing health services and information, and providers’ challenges delivering care during and after COVID-19. Methods: Following a nationwide online survey with 228 HCPs in Canada, in-depth qualitative interviews were conducted with 24 survey respondents to obtain their insights. Data were analyzed using qualitative content analysis. Results: HCPs reported that the pandemic introduced novel challenges due to the lack of training and technical resources to facilitate healthcare communication with their patients with DSL. HCPs faced difficulty in clinical assessments and diagnosis due to restrictions while using PPE, such as masks. Participants reported strategies such as alternative formats, use of gestures or pictures, assistive devices, and caregiver support and accompaniment that helped provide services to older adults with DSL. Conclusions: Study findings suggest that older adults with DSL were underserved during the pandemic and underscore the need for continuing education/training on DSL for HCPs in order to provide better care to this group. Full article

Background/Objectives: Artificial intelligence (AI) is increasingly embedded in menstrual and reproductive health applications, yet little is known about how women in conservative, rapidly digitizing regions evaluate AI-enabled menstrual tracking tools. This study investigates how perceived cultural fit and data privacy concerns are associated with women’s openness to AI-enabled menstrual tracking in Gulf Cooperation Council (GCC) countries. Methods: We conducted an online cross-sectional survey using a convenience sample of adult women residing in GCC countries (n = 273), measuring openness to AI menstrual tools, perceptions of cultural fit (e.g., respect for religious and cultural norms, endorsement by trusted institutions, Arabic language, GCC-specific design), privacy concerns (e.g., worries about who can access menstrual health data), and key sociodemographic characteristics and smartphone use. Results: Higher perceived cultural-contextual fit was strongly and positively associated with openness to AI-enabled menstrual tracking, whereas composite privacy concerns showed no statistically significant association once cultural fit and sociodemographic factors were controlled. Item-level analyses indicated that beliefs about cultural sensitivity and GCC-specific design were the most robust predictors of openness, while concerns about data access, authority endorsement, and language accessibility played a limited role. Homemakers reported higher openness than employed women. Conclusions: Overall, the findings suggest that, in this sample and model, GCC women’s openness to AI-enabled menstrual tracking was more strongly associated with perceived cultural alignment and local design than with the measured privacy-concern construct, highlighting the importance of culturally grounded, trust-building design and communication strategies for AI-based women’s health applications. Full article

Background and Objectives: Rare diseases collectively affect large populations and require coordinated, patient- and caregiver-informed health and social support. This study had an overarching descriptive objective to characterize patient- and caregiver-reported experiences of living with rare diseases in Türkiye and a secondary exploratory objective to assess differences across broad disease categories. Materials and Methods: This cross-sectional, anonymous, voluntary non-probability online survey recruited affected individuals and relatives/caregivers through patient-organization networks. The 44-item questionnaire covered sociodemographic and caregiving context, diagnostic experiences, psychosocial support, healthcare access, and service-improvement priorities. Descriptive analyses, exploratory disease-group comparisons, Cramér’s V, and selected multivariable logistic regression models were used. Results: A total of 1642 responses were analyzed; 76.7% were completed by relatives/caregivers, and 66.4% concerned patients younger than 18 years. Among participants diagnosed after symptom onset (n = 1388), 34.4% reported an incorrect or alternative diagnosis and 64.0% sought at least one additional specialist opinion. Psychosocial support was needed by 74.2%, whereas 34.5% reported receiving professional support. Access to current treatment services was perceived as moderately adequate by 29.3% and adequate by 13.0%. The leading service-improvement priorities were increasing healthcare professionals’ knowledge (82.9%) and establishing specialized rare-disease centers (79.5%). Conclusions: This patient-organization-recruited survey provides a large descriptive account of the experiences and priorities reported by participating patients and caregivers. The findings identify perceived priorities, particularly clinician education and specialized centers, while not constituting nationally representative estimates. Full article

Background: Population aging has led to an increasing proportion of older adults (aged 65 and older) acting as informal caregivers. These caregivers face risks of burden, stress, and depression. While research frequently documents negative psychological outcomes, resilience represents a crucial protective process. This systematic review synthesizes and maps the empirical evidence regarding the association between the socio-ecological resilience process and the well-being of older informal caregivers. Methods: Following Joanna Briggs Institute (JBI) mixed-methods guidelines, a convergent segregated mixed studies systematic review was conducted. A systematic search of Medline (PubMed), CINAHL, PsycINFO, and Scopus identified primary articles (2014–2025) in English and Spanish. Methodological quality was appraised using JBI critical appraisal checklists and the Mixed Methods Appraisal Tool. PROSPERO registration number: CRD420251142190. Results: Thirty-one studies were included. Elevated caregiver resilience was associated with lower reported symptoms of depression and anxiety, higher self-rated health, and positive psychological adaptation. Framed within a social ecological model, personal resources such as spirituality, hope, and self care, alongside relational assets like dyadic relationship quality and mutual coping, demonstrated a positive association with resilience and a reduction in subjective burden. Within the community context, informal peer networks and Online Health Communities functioned as essential supportive resources. On a structural level, both household wealth and the regional availability of long-term care beds acted as moderators for spousal well-being, whereas exceeding 30 weekly caregiving hours acted as a temporal threshold for positive adaptation. Conclusions: These findings suggest that resilience in older caregivers may be best conceptualized not as a static individual trait, but as a multi-level, dynamic socio-ecological process. Rather than relying on individual coping alone, public policies and clinical practice should prioritize systemic, relational, and structural environmental support, including formal respite services and long-term care infrastructure, to preserve the well-being of older spousal caregivers. Full article

Background/Objectives: Veterinarians are exposed to substantial psychological strain, including burnout, depressive symptoms, and increased suicide risk. Emotional and ethical challenges, such as managing animal suffering, making difficult treatment decisions, and handling conflicts with animal owners, may compound the pressures associated with demanding working conditions. This study aimed to investigate occupational stressors, working conditions, job satisfaction, and self-reported mental health among veterinarians working in Germany. Methods: An exploratory, quantitative, cross-sectional online survey was conducted among veterinarians working in Germany between August and October 2025. A total of 126 veterinarians completed the questionnaire. Associations between demographic and professional characteristics, working conditions, occupational stressors, and self-reported mental health indicators were analyzed using Pearson’s chi-square tests, Mann–Whitney U tests and Kruskal–Wallis tests. Results: The greatest perceived occupational stress was associated with work–life balance and working hours (mean ± SD: 3.67 ± 1.14), followed by the management of complex medical cases and communication with animal owners. Younger veterinary respondents reported greater stress related to selection of treatment options, whereas older and more experienced veterinary respondents reported greater stress related to administrative workload. Women reported higher stress levels across several domains, including communication with animal owners and the management of difficult medical cases. Veterinarians working more than 40 h per week reported lower satisfaction with work–life balance, while those with more than 28 days of annual leave reported greater workplace comfort. Self-reported stress-related symptoms were frequently indicated in the symptom checklist: 63.5% reported sleep disturbances, 31.7% burnout symptoms, and 26.2% anxiety. Only 19.0% had sought psychological help for work-related stress, and workplace psychological support was available and used by only 3.2% of respondents. Conclusions: The exploratory findings indicate substantial perceived work-related, emotional, and ethical burdens among veterinarians working in Germany. Improved working-time arrangements, administrative support, accessible psychological support, and broader organizational measures may help protect veterinarians’ well-being and long-term job satisfaction. Full article

Background/Objectives: School-based food and nutrition education is an important public health strategy for developing healthy dietary behaviors during childhood and adolescence. However, limited qualitative evidence describes how nutrition teachers, who are simultaneously responsible for school meals, perceive established educational priorities and emerging needs. This study explored current and future priorities for school-based food and nutrition education in South Korea. Methods: Two online focus group interviews were conducted with eight nutrition teachers working in elementary, middle, and high schools. The interviews were transcribed and analyzed using qualitative content analysis procedures. Results: Current priorities included foundational nutrition and food-related knowledge, balanced eating, environmental issues, low-sodium and low-sugar diets, understanding school meals, prevention of eating disorders and chronic diseases, and table manners and picky eating. Future needs centered on food choice and food literacy, sustainable diets, interdisciplinary education, and understanding diverse food cultures. Across themes, participants described a shift from primarily knowledge-focused instruction toward applied dietary competence, a broadening from individual disease prevention toward health and sustainability, and stronger integration of classroom education with school meals and other subjects. Conclusions: From the perspectives of the participating nutrition teachers, the findings provide formative evidence for curricula and interventions that combine foundational nutrition science with food-choice skills, age-appropriate preventive messages, sustainable dietary practices, and opportunities for behavioral application in the school meal setting. Future quantitative and intervention studies, including nationally representative samples, are needed before robust national priorities can be established. Full article

Background/Objectives: As patients increasingly rely on online health information, this study aimed to evaluate and compare the quality, understandability, actionability, and reliability of YouTube videos concerning dental implant and denture maintenance. Methods: A video search was conducted in February 2026 using the English terms “dental implant care,” “dental implant cleaning,” “denture care,” and “denture cleaning.” The top 50 implant care videos and top 50 denture care videos meeting preset selection criteria were analyzed. Video metadata and dislike metrics were documented. Content characteristics were independently assessed by two researchers using the Global Quality Scale (GQS), the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V), and JAMA benchmark criteria. Results: Denture care videos attracted significantly higher user engagement compared to implant videos (p < 0.05). However, despite lower engagement, implant care videos demonstrated significantly superior overall quality (GQS: 3.25 vs. 2.74, p = 0.017) and understandability (p = 0.004) compared to denture videos. While implant video quality did not differ by provider, denture videos uploaded by health portals and professionals scored significantly higher than commercial or layperson sources (p < 0.05). Notably, video popularity metrics (views, likes) showed little to no correlation with actual educational quality. Conclusions: YouTube implant care videos exhibit moderate quality, whereas denture care videos are low to moderate. Since video popularity does not guarantee clinical accuracy, dental professionals should proactively guide patients toward high-quality, verified educational resources. Full article

Background/Objectives: Dental caries remains one of the most prevalent chronic diseases in childhood, influenced by a combination of hygiene, dietary, and access-related behaviours that are largely shaped by parental involvement. This study aimed to evaluate oral hygiene habits, dietary risk factors, access to dental services, awareness of caries prevention, and the impact of oral health on the child, in relation to parent-reported dental caries in Romanian children and adolescents. Methods: A cross-sectional study was conducted using a structured online questionnaire completed by parents or legal guardians of 508 children and adolescents aged under 18 years. Associations between categorical variables and reported caries were assessed using chi-square tests and Cramér’s V. Ordinal variables were compared using the Mann–Whitney U test. A multivariable logistic regression identified independent predictors of reported caries, with robustness examined through sensitivity analyses. Results: Parent-reported caries was present in 61.2% of children. The strongest associations with caries were the absence of parental supervision during brushing (Cramér’s V = 0.364), the age at which children began brushing unsupervised (V = 0.354), and the reason for the last dental visit (V = 0.426). In the multivariable model, older age, absence of brushing supervision, sweets before bedtime, less frequent dental visits, and rural residence were independent predictors (all p < 0.05; Nagelkerke R² = 0.361). All six assessed dimensions of oral-health impact on the child were significantly associated with caries, with physical discomfort showing the largest effect (V = 0.349). Conclusions: Parent-reported caries risk in this population clustered around a small number of modifiable behaviours rather than any single dominant factor, while reported caries was associated with a substantial burden on children’s daily functioning. These findings point to sustained parental supervision and routine, non-symptomatic dental care as priority targets for future prevention efforts, although intervention studies are needed to confirm their effectiveness. Full article

Background: Antimicrobial resistance is a growing global health challenge, particularly in low- and middle-income countries where antimicrobial stewardship (AMS) implementation and leadership capacity remain limited. Pharmacists play a central role in AMS but often lack access to structured leadership development. To address this gap, the Commonwealth Pharmacists Association developed the UK–Africa Leadership Fellowship in Antimicrobial Stewardship (UK-ALF-A), a 12-month bidirectional leadership development programme combining online learning modules, live webinars, peer-learning sessions, dual mentorship from UK- and Africa-based mentors, and workplace-based AMS continuous quality improvement projects. UK-ALF-A was designed to strengthen leadership capability among pharmacists in the United Kingdom and sub-Saharan Africa. Methods: This study evaluated changes in leadership capability among pharmacists participating in the programme and explored how fellows applied these capabilities within AMS-related practice. A mixed-methods evaluation was conducted with 40 fellows (20 UK, 20 Africa), using pre- and post-programme self-assessments and 360-degree colleague feedback based on the International Pharmaceutical Federation Global Advanced Development Framework (FIP GADF), alongside post-fellowship surveys and semi-structured interviews. Results: The proportion of fellows self-assessing at the highest competency level increased from 10% pre-programme to 39% post-programme, with corresponding increases in colleague feedback ratings from 17% to 49%. Qualitative data from open-ended survey responses and semi-structured interviews suggested improvements in leadership confidence, communication, and ability to influence AMS practice. Fellows reported leading prescribing improvements and multidisciplinary engagement, often without formal authority, with greater relative gains observed among Africa-based participants. Conclusions: UK-ALF-A was associated with enhanced leadership capability and contributions to AMS practice, alongside reported changes in individual and organisational practices that support broader health system strengthening, highlighting its value as a workforce development model. Full article

School-based prevention programs increasingly incorporate mental health-related components to prevent substance use among adolescents. This study aimed to evaluate the effectiveness of integrated school-based mental health and substance use prevention programs for adolescents through a systematic review and meta-analysis. A systematic literature search was conducted across 12 electronic databases for studies published between January 2016 and April 2026. Randomized controlled trials (RCTs) and cluster randomized controlled trials evaluating school-based integrated prevention programs for adolescents were included. Random-effects meta-analyses were performed for substance-use outcomes, including alcohol-related outcomes and binge drinking, using pooled odds ratios (ORs) and 95% confidence intervals (CIs). Mental health and psychosocial outcomes were synthesized narratively because heterogeneity in outcome definitions, measurement instruments, and assessment periods precluded meaningful quantitative pooling. A total of 16 reports representing 10 independent trials were included in the systematic review, and five independent trial comparisons were included in the primary meta-analysis. Integrated prevention programs significantly reduced alcohol-related behaviors among adolescents compared to control groups (OR = 0.56, 95% CI = 0.37–0.86, p = 0.008). Significant preventive effects were also observed for binge drinking outcomes (OR = 0.32, 95% CI = 0.16–0.64, p = 0.001). Most interventions incorporated emotional regulation, resilience enhancement, coping skills, stress management, and help-seeking promotion. Digital and online approaches were frequently used. Narrative findings suggested potential benefits for selected psychosocial and mental health-related outcomes; however, these outcomes were not quantitatively pooled and were not consistently sustained across follow-up periods. Integrated school-based prevention programs incorporating mental health-related components demonstrated beneficial effects on alcohol-related behaviors and binge drinking among adolescents. Evidence regarding mental health and psychosocial outcomes was based on narrative synthesis and remains less conclusive. These findings support the importance of integrated prevention approaches that simultaneously address substance use and mental health in school settings. However, additional large-scale RCTs with standardized outcome measures and long-term follow-up are needed to strengthen the current evidence base. Full article

Extra virgin olive oil (EVOO) is a key component of the Mediterranean diet and a functional food whose health properties are mainly attributed to phenolic compounds. Despite the availability of EFSA-approved health claims, consumers often rely on heuristic cues that may not correspond to scientifically recognized quality indicators. A cross-sectional online survey involving 516 Italian consumers was conducted to investigate consumption patterns, health-related beliefs, territorial identity, and sensory quality perception. Descriptive analyses, regional comparisons, and a multivariable logistic regression model predicting sensory misperception were performed. Most respondents reported frequent EVOO consumption and willingness to pay a premium for certified products. Territorial identity, trust in local producers, and origin-related cues emerged as important dimensions of quality perception. Although respondents generally recognized the health relevance of antioxidants and unsaturated fatty acids, misconceptions regarding sensory indicators were common. Specifically, 41% of respondents associated sweetness with EVOO quality, whereas bitterness and pungency were less frequently recognized. Greater perceived knowledge of EVOO health properties was associated with a lower likelihood of identifying sweetness as an indicator of EVOO quality. Overall, consumer evaluation of EVOO reflected the interaction of informational, symbolic, and experiential dimensions, highlighting the potential relevance of communication strategies and sensory education initiatives whose effectiveness should be evaluated in future research. Full article

Black carbon is an important light-absorbing component of atmospheric particulate matter, with significant implications for urban air quality, climate forcing, human health, and sustainable urban development. Reliable monitoring of black carbon is therefore essential for assessing combustion-related pollution and supporting sustainable air quality management and emission-reduction strategies. This study evaluated the performance of the Multi-Wavelength Absorption Black Carbon Instrument for the offline determination of aerosol light absorption and equivalent black carbon under contrasting urban conditions. PM_2.5 and PM₁₀ samples were collected at urban-background sites in Krakow, Poland, and Athens, Greece, during winter and summer 2024, thereby covering heating and non-heating periods and a broad range of aerosol concentrations. Samples were collected in parallel on Quartz-fibre and Teflon filters. Their light absorption was measured offline using the Multi-Wavelength Absorption Black Carbon Instrument at 870 nm. Elemental carbon concentrations were independently determined on Quartz-fibre filters by thermo-optical transmittance using the EUSAAR_2 protocol, while continuous absorption measurements from an AE33 Aethalometer operated in Athens were used to assess the comparability of offline and online measurements. The consistency of two independent Multi-Wavelength Absorption Black Carbon Instruments operated in Krakow and Athens was also examined using a common set of filters. Strong linear relationships were observed between the offline absorption coefficients and elemental carbon concentrations, with coefficients of determination exceeding 0.90 for the investigated datasets. The offline measurements also reproduced the variability observed by the AE33, although they systematically yielded higher absorption coefficients than the continuous instrument. Quartz-fibre filters produced higher absorption values and higher apparent mass absorption cross-sections than Teflon filters, demonstrating a pronounced substrate-dependent effect. The differences in the quartz-based relationships between Krakow and Athens indicated that aerosol composition, source characteristics, ageing, and mixing state may also affect the relationship between optical absorption and elemental carbon concentration. These findings confirm that the instrument is suitable for offline and retrospective assessment of equivalent black carbon, particularly where continuous monitoring is unavailable. Reliable quantitative application requires filter-specific calibration and, where necessary, site-specific mass absorption cross-section values. By enabling the use of archived and routinely collected filter samples for black carbon assessment, this approach can complement continuous monitoring networks and support more accessible and sustainable air quality monitoring. Such measurements can contribute to the evaluation of pollution trends, emission-control measures, and evidence-based strategies aimed at improving urban environmental quality and advancing sustainability goals. Full article

Background: Cancer pain remains highly prevalent and undertreated despite established guidelines. In Italy, Law 38/2010 mandates systematic pain assessment, yet only 26% of clinicians routinely evaluate pain at each clinical visit, and fewer than one-quarter have received formal training in pain medicine or palliative care. A national multidisciplinary roundtable, convened in Rome in March 2025, formally identified four systemic gaps—insufficient education, fragmented care pathways, unclear professional roles, and challenges in implementing shared diagnostic and therapeutic pathways—and planned the development of a structured Delphi consensus. Methods: A Delphi consensus process was undertaken in accordance with CREDES guidelines. The Steering Committee, comprising representatives of six Italian scientific societies (AIRO, AIOM, AISD, Federdolore-SICD, SICP, ACD-SIAARTI) and a patient advocacy group (Fondazione Nora e Alberto Gentili), developed 15 clinical statements addressing pain assessment, management, referral criteria, monitoring, and documentation over five online meetings held between March and September 2025. Sixty-six Italian clinicians from various specialties were invited to participate; the survey was open from 1 October to 31 December 2025, with reminders every 10 days. Consensus was defined as ≥75% agreement (scoring 4 or 5 on a 5-point Likert scale). Results: Fifty-six clinicians completed the survey (response rate: 84.8%), representing medical oncology, radiation oncology, pain therapy, and palliative care specialties; individual statements were rated by 53–54 panelists, as skipping single items was permitted. All statements reached consensus in the first round (77.8–100%), precluding the need for a second voting round. Panelists’ qualitative comments informed minor wording refinements; substantial content was unchanged. Conclusions: The Delphi process produced a validated, multidisciplinary clinical pathway for cancer pain management in the Italian National Health System (NHS). The pathway establishes structured roles for the clinical reference physician and specialist consultants, objective decision thresholds for analgesic titration and referral, and minimum requirements for standardized pain documentation. These consensus-based statements provide actionable clinical guidance that may help address analgesic undertreatment and support the implementation of Law 38/2010 across Italian oncology centers. Full article