Adolescents experiencing emotional distress are at increased risk of developing mental health problems, which can negatively impact their academic performance, social relationships and long-term well-being. Schools provide a key setting for implementing preventive interventions that promote emotional and psychological resilience. This study presents the protocol for a randomised controlled trial designed to evaluate the effectiveness of a multicomponent, school-based intervention grounded in emotional intelligence (EI) in improving mental well-being, EI levels and resilience among adolescents aged 14–16 years experiencing emotional distress.
The trial will be conducted in public and publicly funded secondary schools in Terrassa, Spain, during the 2025–2026 academic year. Eligible participants will be identified using the short version of the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). The intervention consists of nine 55-minute group sessions delivered during school hours by a nurse and a physiotherapist, supported by the school’s psychopedagogue. Sessions focus on emotional regulation, self-esteem, mindfulness, assertiveness and other socio-emotional skills. Assessments will be conducted at baseline, postintervention and 24-week follow-up. The primary outcome is mental well-being (WEMWBS); secondary outcomes include EI (Trait Meta-Mood Scale-24 items) and resilience (Child and Youth Resilience Measure-32 items). It is anticipated that adolescents in the intervention group will show significantly greater improvements in mental well-being, emotional intelligence and resilience compared with the control group, with effects sustained at follow-up. This study will provide evidence on the effectiveness of a scalable, school-based intervention led by community health professionals. The programme could be integrated into educational and public health strategies to promote adolescent mental health and reduce emotional distress.
Approved by CEIm Consorci Sanitari de Terrassa (01-24-1CR-102). Low-risk study; predefined procedures are in place for participants at risk (eg, suicidal ideation, abuse) with referral pathways to health/social services. Findings will be disseminated via peer-reviewed publications, conferences and a plain-language summary to schools/stakeholders.
Non-specific low back pain (NSLBP) is one of the leading causes of disability worldwide. Emerging evidence suggests that altered diaphragmatic function may be associated with lumbar pain, impaired trunk stabilisation and functional disability. Manual diaphragmatic techniques have been proposed as an intervention to modulate diaphragmatic tension, mobility and neuromyofascial relationships; however, their effectiveness has not yet been synthesised using rigorous systematic review methods.
This protocol follows Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidance and has been prospectively registered in PROSPERO. Randomised controlled trials evaluating manual techniques specifically applied to the diaphragm in adults with NSLBP will be eligible. The primary outcomes will include pain intensity and functional disability; secondary outcomes will include lumbar mobility, respiratory function, quality of life and adverse events. Searches will be performed in PubMed/MEDLINE, Cochrane CENTRAL, PEDro, CINAHL, Scopus, Embase and clinical trial registries without language or date restrictions. Two reviewers will independently perform study selection, data extraction and risk-of-bias (RoB) assessment using the Cochrane RoB 2 tool. Where appropriate, a random-effects meta-analysis will be conducted; the certainty of evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation approach. Substantial clinical and methodological heterogeneity is anticipated across trials, which may limit the feasibility of quantitative data pooling.
As this study uses data from previously published trials, ethical approval is not required. Findings will be disseminated through peer-reviewed publication, conference presentations and a plain-language summary for clinical stakeholders.
CRD420251172616.
Inflammation plays a central role in atherosclerosis development and subsequent cardiovascular complications, including heart attack and stroke. Patients with inflammatory conditions such as community-acquired pneumonia (CAP) present with an elevated risk of cardiovascular events, which is likely driven by unresolved systemic inflammation. Targeting this heightened inflammatory burden may present a novel therapeutic strategy to attenuate heart attack risk in CAP survivors. Icosapent ethyl (IPE), an omega-3 fatty acid, demonstrates both pro-resolving and cardioprotective properties. The Targeting Vascular Inflammation In Patients with CAP (TIN-CAP) trial aims to evaluate the efficacy of IPE in mitigating vascular inflammation in CAP survivors.
TIN-CAP is a multicentre, randomised, double-blind, placebo-controlled trial. Eligible adults diagnosed with CAP in hospital or the emergency department will complete baseline assessments within 14 days of diagnosis including 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT angiography, bloodwork and quality of life evaluation (EuroQol – 5 Dimensions (EQ-5D)). Participants will then be randomised 1:1 to receive IPE (4 g/day) or placebo for 6 months. Follow-up visits will occur at 30 days (bloodwork and EQ-5D only) and 6 months. The primary endpoint is the change in FDG uptake in the ascending aorta from baseline to 6 months between IPE and placebo groups. Secondary endpoints include FDG uptake in the bone marrow, spleen, lungs and other vasculature, in addition to major adverse cardiac events and quality of life assessments. An initial lead-in cohort of 18 patients will be enrolled to assess recruitment, imaging feasibility and IPE tolerability prior to full trial enrolment. These patients will remain blinded and will be included in the final analysis (Vanguard design).
The TIN-CAP trial has been approved provincially by the Clinical Trials Ontario Research Ethics Board (approval number: 5045). Participants will provide written informed consent prior to enrolment. Study findings will be disseminated through peer-reviewed publications and conference presentations.
Gestational weight gain (GWG) is an important indicator of maternal nutrition to be monitored during pregnancy. However, there is no evidence-based tool that can be used to monitor it across all geographic locations and pre-pregnancy body mass index (BMI) categories. The WHO is undertaking a project to develop GWG charts by pre-pregnancy BMI category, and to identify GWG ranges associated with the lowest risks of adverse maternal and infant outcomes. This protocol describes all the steps that will be used to accomplish the development of these GWG charts.
This project will involve the analysis of individual participant data (researcher-collected or administrative). To identify eligible datasets with GWG data, a literature review will be conducted and a global call for data will be launched by the WHO. Eligible individual datasets obtained from multiple sources will be harmonised into a pooled database. The database will undergo steps of cleaning, data quality assessment and application of individual-level inclusion criteria. Heterogeneity of maternal weight and GWG will be assessed to verify the possibility of combining datasets from multiple sources and regions into a single database. Generalized Additive Models for Location, Scale and Shape will be applied for the construction of the centile curves. Diagnostic measures, internal and external validation procedures will also be performed.
This project will include an analysis of existing study de-identified data. To be included in the pooled database, each included study should have received ethics approvals from relevant committees. Manuscripts will be submitted to open-access journals and a WHO document will be published, including the GWG charts and cut-offs for application in antenatal care.
Cardiovascular diseases, overweight, type 2 diabetes and chronic kidney disease increase the risk of cardiovascular events.
Glucagon-like peptide-1 analogues are recommended by the European Society of Cardiology and the American College of Cardiology to lower the risk of death and progression of cardiovascular disease in patients with cardiovascular disease and type 2 diabetes. Semaglutide, tirzepatide and liraglutide are approved by the US Food and Drug Administration and the European Medicines Agency for the treatment of type 2 diabetes mellitus and overweight. CagriSema is currently not approved, but several phase III trials are ongoing.
No previous systematic review has investigated the effects of semaglutide, tirzepatide, CagriSema and liraglutide, which may not be disease-specific, on hard binary outcomes for all trial populations at increased risk of cardiovascular events.
We will conduct a systematic review and search major medical databases (Cochrane Central Register of Controlled Trials, Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Latin American and Caribbean Health Sciences Literature, Science Citation Index Expanded, Conference Proceedings Citation Index—Science) and clinical trial registries from their inception and onwards to identify relevant randomised trials. We expect to perform the literature search in December 2025. Two review authors will independently extract data and assess the risk of bias. We will include randomised trials assessing the effects of semaglutide, tirzepatide, CagriSema and/or liraglutide in participants with an increased risk of cardiovascular events. The primary outcome will be all-cause mortality. Secondary outcomes will be myocardial infarction, stroke and all-cause hospitalisation. Data will be synthesised by aggregate data meta-analyses, Trial Sequential Analyses and network meta-analysis, risk of bias will be assessed with Cochrane Risk of Bias tool V. 2, and the certainty of the evidence will be assessed by Grading of Recommendations, Assessment, Development and Evaluations and the Confidence in Network Meta-Analysis approach.
This protocol does not present any results. Findings of this systematic review will be published in international peer-reviewed scientific journals.
CRD42024623312.
To characterise and analyse doctoral programmes in nursing in Latin America through an exhaustive review of the official websites of the universities.
Descriptive and multiple correspondence analysis. Existing programmes were mapped out, identifying their geographic distribution and curricular characteristics.
A review of 59 doctoral programmes in nursing was conducted through the official web portals of universities in Latin America that were currently available (as of 2025) and that provided the required information. Thereafter, a matrix was built in Excel to consolidate the data.
The study identified an increase in the number of doctoral programmes in nursing offered in Latin America. Furthermore, these programmes were found to be more strongly concentrated in countries such as Brazil, Peru and Mexico, while other countries, including Guatemala and Uruguay, have recently incorporated such training.
Doctoral education in nursing in Latin America has experienced significant growth in recent years, consolidating itself as a fundamental pillar for the development of the discipline and the generation of knowledge in health. However, structural challenges persist, including limited funding for research, a lack of cooperation between universities, and the absence of programmes focused on Advanced Nursing Practice.
This contribution helps identify trends in the offering of doctoral programmes and inequalities in their geographic distribution, allowing for an understanding of how training varies across countries in the region while also consolidating Nursing as an academic and professional discipline.
by Andy Domínguez-Monterroza, Alfonso Mateos Caballero, Antonio Jiménez-Martín
Heart rate variability (HRV) is a well-established marker of autonomic regulation and undergoes profound maturation during early human development. In this study, topological data analysis (TDA) is applied to investigate the evolving geometric complexity of HRV across pediatric developmental stages. Using persistent homology in homological dimension 1, we extracted topological descriptors from time-delay embedded RR interval series of 127 individuals aged 1 month to 17 years. We identified statistically significant, age-dependent transformations in the topological structure of HRV signals. Neonates and infants exhibited a greater number and strength of persistent features, reflecting highly heterogeneous cardiac control dynamics during early autonomic maturation. In contrast, adolescents displayed reduced topological complexity and increased entropy, suggesting a shift toward more uniform and structured physiological control. Topological measures correlated with conventional HRV indices, confirming their physiological relevance. Furthermore, pairwise distances between persistence landscapes revealed an inverse relationship between intra-group topological variability and classical HRV measures. Collectively, our findings demonstrate that persistent homology provides a powerful, multiscale-aware framework to capture developmental trajectories in cardiac autonomic regulation, with potential applications in pediatric monitoring, developmental physiology, and early detection of dysautonomia.To identify sex-specific patterns based on determinants related to sleep quality, using a representative sample of the Spanish adult population.
Cross-sectional, age-stratified and sex-stratified study.
Community-based assessments in two Spanish provinces (Salamanca and Ávila).
Adults aged 25–65 years (n=500), equally distributed by sex and five age strata, selected from the regional health-card database.
Objective sleep metrics from wrist actigraphy (time in bed, total sleep time (TST), sleep efficiency, wake after sleep onset, number/duration of awakenings, fragmentation/movement indices) and self-reported sleep quality (Pittsburgh Sleep Quality Index).
Standardised baseline assessments collected sociodemographic, clinical, mental-health and lifestyle variables using validated instruments. Actigraphy (ActiGraph GT3X+) recorded triaxial acceleration at 30 Hz over 5 days; data were aggregated in 60 s epochs (ActiLife). Sleep/wake was classified with Cole-Kripke and nocturnal episodes identified with Tudor-Locke before deriving sleep indices. Two-step cluster analysis was applied separately by sex.
Three clusters were identified for each sex, with age and educational level being the most influential factors. In men, the 65-year-old cluster with university education and lower anxious–depressive load showed the highest sleep efficiency (91.8±3.8%) and the lowest TST (351.7±74.8 min). In contrast, the 35-year-old cluster with middle or high school presented the lowest efficiency (88.3±10.0%) and higher TST (368.1±83.8 min). In women, the 55-year-old cluster with middle or high school and low emotional load showed the highest efficiency (93.6±2.8%), despite a reduced TST (352.0±79.7 min), while the 35-year-old cluster, with middle or high school and high levels of anxiety and depression, showed the worst efficiency metrics (89.5±3.9%) and a higher TST (394.8±67.3 min).
Sleep quality in Spanish adults is heterogeneous across sex-specific clusters shaped by age, education and mental-health burden. Cluster-based characterisation may support tailored public-health interventions.
Digital technology can be effective in providing personalised healthcare in contexts of ageing societies and increasing international migration trends. However, the literature is scarce and unsystematic, considering healthy ageing in migrant populations. This knowledge gap delays the development of interventions, policies and technology that are inclusive of the healthcare needs and limitations in older migrants. We aim to map the scientific literature addressing structural, psychological, technical and ethical determinants to adoption, use and effectiveness of digital technology for healthy ageing in migrants. We aim to uncover major challenges, highlight solutions and derive an agenda for future research.
We plan a scoping review of peer-reviewed articles published in English, German and Spanish after 2010 without a geographical limitation. We will perform the review across specialised and interdisciplinary databases (EBSCO, IEEE Xplore, IET Digital Library, PsycINFO, PubMed, Scopus and Web of Science) and manage articles at Covidence.org. Our review will adhere to the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review guidelines for conducting and reporting reviews.
No primary data will be collected, and therefore, ethical approval is not required.
The results of this scoping review will be published in a peer-reviewed outlet and presented at conferences. A shiny web application will accompany the publication.
Cytomegalovirus (CMV) infection is a common complication in patients undergoing haematopoietic stem cell transplantation (SCT). Letermovir (LTV) prophylaxis during the first 100 days post-SCT is effective and safe in preventing this infection, although it may be associated with a delay in CMV-specific immune reconstitution. Hence, a study is needed to evaluate whether the absence of CMV-specific immune reconstitution at the end of LTV prophylaxis is associated with the development of late infection. This could facilitate the individualisation of CMV prophylaxis duration in these patients.
INMUNOEND is a multicentre, prospective, observational, non-interventional study including CMV seropositive patients undergoing allo-SCT who receive LTV prophylaxis during the first 100 days post SCT. Immunological and virological monitoring will be conducted until day+200 post-SCT. The primary outcome is the percentage of patients who develop clinically significant CMV infection up to day+200 post-SCT after completing LTV prophylaxis. Data collected will include baseline characteristics of the haematological diseases and comorbidities, variables related to SCT (ie, engrafment, graft-versus-host disease, use of LTV and CMV replication) and variables related to CMV-specific immune reconstitution.
Ethical approval has been obtained from the institutional review board (Comité de Ética de la Investigación de Córdoba; SICEIA-2024–0 01 762). The results of this study will be published in peer-reviewed journals and disseminated at national and international conferences.
Objetivo. Comparar la percepción de la calidad de vida relacionada con la salud (CVRS) tras la COVID-19 en función del sexo. Metodología. Estudio observacional descriptivo y transversal en pacientes post-COVID de neumología-medicina interna del Complejo asistencial de Zamora, diagnosticados de COVID-19 al menos 3 meses antes. La CVRS se valoró mediante el cuestionario EQ-5D-5L. Resultados. Se incluyeron 192 pacientes, 91 mujeres (47,4 %), edad 57±13 años. 127 pacientes (66,0%) reflejaron un EQ-5D Index < 1, lo que supone una merma en su CVRS. En el análisis comparativo en función del sexo, las mujeres manifestaron mayor dificultad para las actividades cotidianas (38 [41,3%] vs. 22 [21,6%]; p=0,003), dolor/malestar de forma habitual (50 [54,3%] vs. 35 [34,3%]; p=0,005) y ansiedad/depresión (48 [52,2%] vs. 38 [37,3%]; p=0,037). La Escala Visual Analógica (EVA) fue mayor en hombres (69,8±18,7 vs. 63,1±19,5; p=0,016), así como el EQ-5D Index (0,84±0,22 vs. 0,76±0,25; p=0,023). La regresión lineal multivariante confirmó que las mujeres tenían una peor autopercepción de la CVRS independientemente del resto de factores analizados, tanto en el EQ-5D Index [b (IC95%): -0,090 (-0,153 a -0,026)] como en la EVA [b (IC95%): -6,858 (-12,083 a -1,633)]. Discusión. El sexo femenino es un factor de riesgo significativo para una peor calidad de vida auto percibida en pacientes que han pasado la COVID-19, con mayor incidencia de ansiedad, depresión, dolor y limitaciones en actividades cotidianas. Estos problemas fueron más prevalentes en mujeres, quienes mostraron diferencias significativamente menores en el índice EQ-5D y la escala EVA en comparación con los hombres.
ABSTRACT
Objective. To compare the health-related quality of life perception (HRQoL) after COVID-19 according to sex. Methodology. Cross-sectional study in post-COVID patients attending neumology and internal medicine consultation rooms at Complejo Asistencial de Zamora, diagnosed from COVID-19, at least 3 months before. HRQoL was evaluated using the EQ-5D-5L questionnaire. Results: 192 patients were included, 91 women (47,4 %), aged 57±13. 127 patients (66,0%) obtained EQ-5D Index < 1, what means a decrease in their HRQoL. Comparative analysis according to sex showed women had higher difficulties for daily activities (38 [41,3%] vs. 22 [21,6%]; p=0,003), usual pain/discomfort (50 [54,3%] vs. 35 [34,3%]; p=0,005), anxiety/depression (48 [52,2%] vs. 38 [37,3%]; p=0,037). Visual Analogue Scale (VAS) was higher among men (69,8±18,7 vs. 63,1±19,5; p=0,016), as well as EQ-5D Index (0,84±0,22 vs. 0,76±0,25; p=0,023). Multivariate linear regression confirmed women had a worse HRQoL perception with independence of the rest of the analyzed factors, in EQ-5D Index [b (IC95%): -0,090 (-0,153 a -0,026)] as well as VAS [b (IC95%): -6,858 (-12,083 a -1,633)]. Discussion: Female sex is a significative risk factor for a worse self-perceived quality of life in patients who had suffered from COVID-19, with a high incidence of anxiety, depression, pain, and limitations for daily activities. These problems were more prevalent in women, who showed significant lower differences in the EQ-5D index and the VAS scale compared to men.
Objetivo principal: la retirada del esmalte de uñas para la medición de los valores de saturación de oxígeno es habitual en la práctica clínica. Sin embargo, su eliminación repercute en el tiempo invertido, el uso de recursos y potenciales conflictos con el paciente. El objetivo es evaluar la influencia del esmalte de uñas en los valores de saturación de oxígeno en pacientes sometidos a pulsioximetría. Metodología: este trabajo sigue el formato estandarizado para la elaboración de un comentario crítico, donde a partir de diez elementos se estructura y se da contenido al trabajo. Resultados principales: Las variaciones debidas a la presencia de esmalte de uñas durante la medición de la saturación de oxígeno no son clínicamente relevantes. Conclusión principal: Se recomienda evitar la eliminación del esmalte de uñas para la medición de la saturación de oxígeno.
Objetivo principal: El tratamiento con insulina basal-bolo es el tratamiento de elección para la hiperglucemia en pacientes hospitalizados con diabetes mellitus tipo 2. La evaluación de glucosa antes de las comidas y a la hora de acostarse mediante la prueba de glucosa capilar a pie de cama es el método estándar de monitorización de glucosa de estos pacientes. Sin embargo, no ofrece las ventajas de la monitorización continua de glucosa, mediante dispositivos como el FreeStyle Libre Pro Flash. Medir la glucosa intersticial cada 5-15 minutos y obtener un perfil glucémico completo de 24 horas de los pacientes hospitalizados son algunas de las virtudes de este dispositivo. Metodología: Este trabajo sigue el formato estandarizado para la elaboración de un comentario crítico, donde a partir de diez elementos se estructura y se da contenido al trabajo. Resultados principales: La prueba de glucosa capilar a pie de cama detecta una proporción menor de episodios de hipoglucemias que la monitorización continua de glucosa. Conclusión principal: Se recomienda la utilización de la monitorización continua de glucosa como método para la vigilancia y control de la glucemia en pacientes con diabetes tipo 2 hospitalizados.
Objetivo principal: Comprender la experiencia en la atención del parto respetado de una mujer atendida en una unidad de partería profesional. Metodología: Estudio cualitativo fenomenológico llevado a cabo en una usuaria con control de embarazo casi exclusivo en la Unidad de Partería seleccionada a conveniencia. Se realizaron entrevistas en profundidad y análisis de contenido. Resultados principales: Surgieron las siguientes categorías que dan sentido a la experiencia de parir: 1) parir con amor, 2) la partera como vía del empoderamiento de la mujer y su familia e 3) Interculturalidad-respeto a las tradiciones. Conclusión principal: El análisis de las categorías muestra que el parto respetado es una vivencia única, personalizada, con resultados positivos tanto para la madre y el recién nacido como para los familiares.
Objetivo principal: Describir la prevalencia de sarcopenia y analizar la influencia de las conductas asociadas del estilo de vida en la sarcopenia en personas mayores residentes de Mexicali, México. Metodología: Se consideró un diseño descriptivo inferencial. Participaron 105 personas mayores de 60 años o más. El muestreo fue no probabilístico. Se evaluaron los criterios diagnósticos para sarcopenia y las conductas asociadas al estilo de vida. La investigación se realizó acorde a la reglamentación ética. Resultados principales: El 24,8% y el 59% presentaron uno de los tres estadios de la sarcopenia acorde a los puntos de corte para la población mexicana y EWGSOP respectivamente. Se encontró asociación con el IMC (p <,01) y sexo (p <,05). Conclusión principal: Se identificó que la prevalencia es menor cuando se consideran los puntos de corte regionales para México. El IMC y el sexo se asociaron con la sarcopenia.
Los nuevos cambios y retos en los servicios sanitarios requieren la incorporación de nuevas respuestas por parte de la profesión enfermera. Este relato biográfico de un enfermero con 23 años de experiencia, tiene como objetivo conocer su experiencia en el ámbito profesional tras trabajar en diferentes áreas y su visión personal. Utilizo una metodología cualitativa descriptiva que permite extraer del discurso del informante un repaso desde sus inicios hasta la actualidad. Cuenta la dificultad para encontrar trabajo y las diferencias que encontró hace 20 años, entre la enfermera portuguesa y la española. Trata temas como el grado en enfermería, la enfermera de practica avanzada, las especialidades y el nivel A1, y la importancia de que la enfermera esté presente en puestos de decisión y políticas sociales. Termina con un pequeño debate entre la vocación y la motivación, y la necesidad de un reconocimiento verdadero por parte de la administración.
Objetivo principal: El desarrollo de flebitis es una complicación frecuente y dolorosa que se produce en la aplicación de catéteres venosos periféricos. Se trata de un comentario crítico que identifica la tasa de desarrollo de flebitis en la aplicación catéter venoso periférico y los factores que afectan al desarrollo de la flebitis. Metodología: El comentario crítico sigue el formato estandarizado para la elaboración de un comentario crítico a partir de los diez elementos estructurados que dan estructura y contenido al trabajo. Resultados principales: Los resultados más importantes son que los factores que afectan al desarrollo de flebitis es la duración del cateterismo, la presencia de una enfermedad crónica y el tipo de líquido utilizado. Conclusión principal: El nivel de evidencia de los resultados según la clasificación GRADE es baja. No obstante, hay significación estadística en los resultados, por lo que se podría recomendar la aplicación de estos hallazgos.
La pandemia causada por la Covid-19 ha afectado a los sistemas de salud y al cuidado de salud de las embarazadas. La educación maternal realizada por las matronas es un factor protector del inicio y mantenimiento de la lactancia y los cuidados del recién nacido. El progresivo incremento de desafíos en la asistencia sanitaria en puérperas lactantes con problemas comunes relacionados tanto con la lactancia materna como con los cuidados del recién nacido durante el estado de alerta por la Covid-19, nos parece oportuno presentar un caso clínico donde se evidencia el papel fundamental de la matrona como profesional clave en todo el proceso relacionado con la atención a la gestante durante el puerperio. La valoración enfermera y recogida de datos se realizan según el modelo de las 14 necesidades de Virginia Henderson y un Plan de Cuidados completo.
Objetivo principal: Analizar la evidencia científica sobre la fototerapia convencional vs la fototerapia con terapia de masaje para la disminución de los niveles de bilirrubina en neonatos a término (37 a 42 SDG) con hiperbilirrubinemia > 5 mg/dL en la terapia intensiva neonatal. Metodología: Enfermería Basada en Evidencia. Bases de datos consultadas: Google académico, PubMed. Elaboración de tablas con los Descriptores en Ciencias de la Salud (DeCS). La lectura crítica se realizó usando CASPe y el nivel de evidencia de acuerdo al Centre for Evidence-Based Medicine, Oxford. Resultados principales: Doce artículos describen que la terapia de masaje aumenta la actividad vagal, dando como resultado una mayor motilidad gástrica y una disminución más rápida de los niveles de bilirrubina. Conclusión principal: la terapia de masaje es una intervención complementaria efectiva durante la fototerapia para reducir los niveles de bilirrubina neonatal.