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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.
To explore the perceptions of nursing professionals in high-demand healthcare services regarding the adoption of AI-based support systems for the prevention of medication errors.
A qualitative descriptive study was conducted between November 2024 and March 2025.
Sixteen semi-structured interviews were held with nurses from emergency and intensive care units, guided by conceptual dimensions of the Technology Acceptance Model framework. Participants were recruited using purposive and snowball sampling. ATLAS.ti v.9 software was used for an inductive thematic analysis.
Two major themes emerged: (i) professional reflections on medication safety and related risks; and (ii) integrating artificial intelligence into nursing practice to reduce such risks and prevent medication errors. While artificial intelligence was recognised as a promising resource to support clinical decision-making and reduce cognitive load, nurses identified barriers, including limited training, inadequate technological infrastructure, unreliable data sources, and ethical concerns that could compromise its safe implementation and thereby hinder its potential to prevent medication errors.
AI-based support systems are perceived as useful, but complex resources for addressing medication errors, which remain a critical challenge in healthcare. Its successful implementation depends not only on the availability of resources, but also on the organisational context and the ability to respond to the needs and concerns of healthcare professionals.
Integrating artificial intelligence into routine workflows to support clinical decision-making and reduce medication errors in high-demand settings requires more than infrastructure and technical training. Effective adoption demands participatory design, clear role delineation, and context-sensitive training aligned with medication-management processes. Lack of alignment may result in artificial intelligence increasing complexity instead of contributing to safer and more efficient medication administration.
Methods and findings are reported following SRQR recommendations.
No patient or public contribution.
To investigate factors influencing the implementation of advanced practice nursing roles within healthcare organisations in seven European countries from the perspective of advanced practice nurses.
A cross-sectional survey was conducted between September 2021 and December 2022, involving advanced practice nurses from Belgium, Finland, Germany, Iceland, Ireland, Spain and the Netherlands. The countries were selected to represent different stages of implementing advanced practice nursing roles, from emerging to well-established.
A self-administered questionnaire was used to address five domains: patient care, practice patterns, policy and legal, educational and workforce-related factors. Descriptive statistics, chi-squared tests and correspondence analysis were employed to identify patterns and country-specific differences across these domains of implementation factors.
A total of 491 advanced practice nurses participated in the study. While almost three-quarters of the participants indicated satisfaction with their job, the study highlighted multifaceted factors influencing the implementation of advanced practice nursing roles across countries. The Netherlands, Ireland and Belgium reported mainly facilitators, whereas Finland, Iceland and Germany noted barriers or a lack of knowledge. Spain mostly reported neutral or moderate positions. Key challenges included role ambiguity, interprofessional collaboration gaps, limited managerial support, workload imbalances, limited mentorship and underutilised competencies. Results also indicated that advanced practice nurses are partially hindered by operating in isolation from other professions.
The findings emphasise the need for robust organisational support, interprofessional collaboration and clear role definitions to facilitate the integration of advanced practice nursing roles. Addressing professional isolation through networking and mentorship is crucial to sustaining the advanced practice nursing workforce.
Policy should prioritise support for advanced practice nursing, including structured mentoring and networking opportunities. Further research on advanced practice nurses' well-being and long-term role sustainability in Europe is recommended.
What problem did the study address? What were the main findings? Where and on whom will the research have an impact?
This study reported factors influencing advanced practice nurse role implementation across seven European countries with different levels of role development. Key challenges included role ambiguity, interprofessional collaboration gaps and limited support. The findings can guide healthcare managers and policymakers on the key factors to consider when integrating advanced practice nursing roles into their teams.
Self-harm and suicidal thoughts and behaviours are a significant public health concern. While individual risk factors have been widely studied, the role of social determinants in shaping these outcomes remains underexplored within policy contexts. This Rapid Realist Policy Review aims to investigate how macro level (national) policies in England address the impact of social determinants of self-harm and suicidal thoughts and behaviours.
This Rapid Realist Policy Review adapts the rapid realist review method to place policy documents at the centre of analysis. It will identify and extract relevant English policy documents (2002–2023) related to suicide, self-harm and mental health, using government and archival databases.
Policy documents will be mapped and categorised based on their pertinence to proximal and distal outcomes and social determinants. A predefined template will be used to extract and appraise data based on relevance, richness and rigour. Context-mechanism-outcome configurations will be developed, validated by content experts and synthesised into an initial programme theory. The review will follow Realist And Meta-narrative Evidence Syntheses: Evolving Standards for realist syntheses.
This review does not require ethical approval due to the use of secondary sources. Findings will be disseminated via an open-access, peer-reviewed journal article. A summary of key recommendations will be produced with the expert stakeholder group to inform policy and practice.
CRD420251057759.
Kerato-lenticule extraction (KLEx) is a refractive surgery technique that, in contrast with femtosecond laser-assisted in situ keratomileusis (FS-LASIK), does not require the creation of a flap to correct refractive defects. The potential advantages of this technique are related to the absence of a flap and its complications. On the other hand, FS-LASIK is the most widely practised refractive surgery worldwide, as it offers excellent visual outcomes and is currently the gold standard of refractive surgery. The objective of this study is to compare the effectiveness and safety of KLEx versus FS-LASIK as a treatment option in patients with myopia or myopic astigmatism.
This double-masked, parallel-group, single-centre randomised clinical trial will enrol 80 eyes from adults with myopia or compound myopic astigmatism within the ranges sphere –0.50 to –12.00 D and cylinder –0.50 to –6.00 D, recruited at the Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico. Participants will be allocated to KLEx or FS-LASIK and assessed at baseline and 1 day, 1 week, 1, 3, 6 and 12 months postoperatively. The primary outcome is uncorrected visual acuity at all postoperative visits. Secondary outcomes include postoperative spherical equivalent, best-corrected visual acuity (BCVA), loss of ≥2 BCVA lines, the proportion of eyes within ±0.50 D of the refractive target, corneal aberrations over a 5 mm pupil, epithelial changes and adverse events. Participants and outcome assessors will be masked to the assigned surgical technique.
Participant confidentiality will be maintained with the publication of results. This study was approved by the research and ethics committee of the Instituto de Oftalmología Fundación de Asistencia Privada Conde Valenciana (CI-017-2024). The study results will be disseminated in scientific articles published in peer-reviewed journals and presented through research posters at national and international conferences.
ClinicalTrials.gov registry (NCT06477081).
People in prison experience disproportionate health burdens compared with community-based populations, including elevated rates of infectious and non-communicable diseases, mental illness and substance use disorders. Previous studies have consistently shown increased rates of mortality following release from incarceration, particularly from external (unnatural) causes such as suicide and violence. However, evidence on mortality incidence during imprisonment is scarce, and many deaths may be preventable through targeted health and prevention interventions. This study aims to synthesise worldwide evidence on all-cause mortality incidence in prisons.
We will conduct a worldwide registry study combined with a systematic literature review and meta-regression analysis. Eligible sources will report deaths among incarcerated people between 2005 and 2025 at the national or, where more appropriate, the subnational jurisdictional level. Mortality data will be retrieved from official reports of prison administrations and direct contact with prison authorities. Also, data from international databases and the scientific literature will be reviewed. Incidence rates of all-cause mortality per 100 000 person-years will be calculated and reported for each jurisdiction, alongside standardised mortality ratios comparing imprisoned populations with general population estimates.
Since the study relies on anonymised routine data registries available from different sources, an exemption certificate was granted by the Ethics Committee of Diego Portales University (UDP) in Santiago, Chile. Findings will be submitted for publication in a peer-reviewed academic journal.
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) entails substantial morbidity and mortality, yet no epidemiologic evidence exists on its outcomes in Mexico. This study assessed national hospitalisations (2005–2022) and mortality (2000–2022) related to AAV using data from the General Board of Health Information.
Retrospective, population-based time-trend analysis on administrative health data.
Mexico’s national hospital discharge and mortality registries, covering 1 January 2000 through 31 December 2022.
All individuals aged ≥ 15 years with a primary or secondary International Classification of Diseases, 10th revision, diagnosis of AAV recorded during hospitalisation or on death certificates nationwide.
The study’s primary outcomes were the age-standardised hospitalisation and mortality rates for AAV (expressed per 100 000 population, overall and by sex), with temporal trends in both rates quantified using Joinpoint regression to calculate annual percent change (APC) and average APC (AAPC).
We identified 2804 hospitalisations and 599 deaths. Females accounted for 49.7% of hospitalisations, while males represented 48.7% of deaths. Although the overall age-standardised hospitalisation rate (ASHR) and mortality rate (ASMR) AAPCs were not statistically significant, relevant trends emerged. From 2010 to 2022, ASHR declined significantly (APC: –5.2%; 95% CI –9.7, –0.5; p=0.03), whereas mortality rates remained stable from 2000 to 2022 (AAPC: +3%; 95% CI –4.6, 11.3; p=0.45). Nevertheless, mortality increased among males (APC: +6.4%; 95% CI 0.9, 12.2; p=0.02) and individuals over 45 years (APC: +8.6%; 95% CI 1.7, 16.0; p=0.02) from 2008 onwards.
Overall, these findings indicate no major changes in national rates but reveal a decline in hospitalisations since 2010 and a rise in mortality for specific subgroups since 2008. Targeted interventions, particularly for older adults and men, appear warranted to address this evolving disease burden. Future research should explore underlying risk factors and evaluate tailored strategies to improve clinical outcomes in AAV across Mexico.
This study aims to assess the association of multimorbidity with capacity impairment in the Chilean population.
Cross-sectional study.
We analysed data from the National Health Survey performed in Chile in 2016 and 2017.
Persons aged 15 years and over were selected using a random, stratified and multistage sampling by clusters in all 15 geographical regions of the country.
We consider the WHO’s definition of multimorbidity as the coexistence of two or more chronic conditions in the same person. For capacity impairment, the survey included 24 items in eight dimensions that represent functioning as a reflection of the overall health experience perceived by an individual with a health condition and interacting with the environment.
The 2016–2017 ENS (Encuesta Nacional de Salud) included 6233 participants (mean age 48.9±19.3, and 62% women). There is an association between impairment of capacity and being a woman (OR=1.62; 95% CI 1.37 to 1.92) and between being under 45 years old and conserved capacity (OR=0.8, 95% CI 0.64 to 0.99). The predictive model determined that women classified with five or more chronic conditions of 80 years and over and with less than 8 years of formal education reach the highest probability of having any impairment of capacity.
Multimorbidity is associated with impaired capacity in the adult population in Chile, and these public health problems are present at early ages and have a greater impact on women.
The needs of patients in palliative care (PC) are multiple and changing. Several tools assess them, but there is a lack of homogeneity among them. A specific diagnostic tool to assess complexity in PC (IDC-Pal: Instrumento Diagnóstico de la Complejidad en Cuidados Paliativos, in Spanish) was created in community and hospital settings with 36 items to diagnose PC complexity, but its application in primary care is difficult.
(1) To generate an adapted version to primary care of the IDC-Pal tool to identify and stratify PC complexity in the adult population. (2) To determine face, content, criterion and construct validity and reliability of the new instrument.
There are three phases of clinimetric cross-sectional observational validation study: Phase 0: Review of the original tool structure suitability for its use in primary care setting by a committee (researchers and the original developer team). Phase 1: Expert consensus phase by Delphi technique with physicians, nurses and social workers from primary care and PC. Phase 2: Empirical validation of the resulting tool in primary care using a cross-sectional descriptive design involving physicians and case manager nurses from across Andalucia, who will recruit adult patients with PC needs from healthcare centres that accept to participate in the study. Reliability (Cronbach’s alpha, McDonald’s omega, interclass correlation coefficient) and construct validity (exploratory factor analysis) analysis will be carried out; convergent criterion validity will be assessed with the NEC-PAL (Necesidades Paliativas Questionnaire, in Spanish) instrument. Differences by gender, type of professional and place where it is administered will be explored. Interobserver reliability analyses will be carried out using intraclass correlation coefficient, Bland-Altman plots and concordance analysis. Phase 0–1 results were expected by 2025 and Phase 2 results by 2026. Reporting method: CRISP checklist. This protocol was conducted without patient or public participation.
This study evaluates a novel, co-designed tool to diagnose PC complexity to inform practice recommendations for a more efficient allocation of resources that may be included in future clinical practice guidelines. The study has been approved by the Provincial Research Ethics Committee of Málaga as of July 2023 and will be conducted in accordance with the principles established in the Declaration of Helsinki, the Council of Europe Convention on Human Rights and Biomedicine, and the requirements established in Spanish legislation. The study conforms to the norms of good clinical practice. All participants in the Delphi study must express their agreement to participate in the survey by providing informed consent (IC) before beginning the questionnaire. For the development of Phase 2, the primary care professionals who agree to participate will sign a researcher commitment, and the patients included in the study will sign a written IC before the data collection. Dissemination of the results will inform future research on the appropriate diagnosis of PC complexity in the primary care setting, which is of paramount importance due to its gatekeeper position. Dissemination will be aimed at academics and healthcare professionals through publications, presentations and training workshops on the use of the diagnostic tool.
El litio es el estabilizador del ánimo en uso más extendido. Posee un estrecho margen terapéutico, siendo tóxico en altas concentraciones. Esta guía va dirigida a profesionales y personas que estén utilizando Litio, pretende facilitar la toma correcta y el buen manejo de esta medicación [Fragmento de texto].
Objetivo principal: Analizar la efectividad del tratamiento de la pediculosis capitis con aceite de coco versus la permetrina o ivermectina para la reducción de la infestación en niños escolares. Metodología: Revisión sistemática con análisis interpretativo. Se consultaron bases de datos como PubMed, ScienceDirect, Epistemonikos, entre otros. Se incluyeron documentos publicados entre 2011 y 2021 derivados de la cadena de búsqueda: aceite de coco AND pediculosis capitis AND efectividad en español e inglés. Resultados principales: Después de aplicar criterios de exclusión y eliminación, se analizaron 10 documentos, que incluían ensayos comunitarios, estudios preclínicos de laboratorio y revisiones sistemáticas, los cuales proponen el aceite de coco como un tratamiento alternativo eficaz contra la pediculosis. Conclusión principal: Aunado a los reportes de alta efectividad de tratamiento, no se reportan efectos adversos y se sugiere el uso de gorra de baño así como un peinado vigoroso con una lendrera para aumentar la efectividad.
Existen millones de personas cooperando internacionalmente en zonas con situaciones críticas. Concurre la posibilidad de que se produzca un choque cultural en estas personas que cooperan, el cual, pueda modificar sus capacidades profesionales y ocasionarles un fuerte impacto emocional. Quetzal, la informante, ha sido médica cooperante durante 10 años en diferentes territorios del mundo, y en su relato desvela la forma en la que el choque cultural se produce y cómo trata de gestionarlo. Se ha realizado un estudio con metodología cualitativa a través del relato biográfico. Se han recogido datos en la entrevista semiestructurada de la informante que fueron clasificados en torno al choque cultural, las situaciones críticas producidas, la información previa y el afrontamiento del choque. Los resultados giran en torno a las vivencias que se producen en la cooperación de la informante, su adaptación psicológica en el momento y su manera de asimilarlo con el paso del tiempo. Se considera la posibilidad de una formación emocional avanzada para convertir el choque cultural en un proceso con un desenlace positivo para las personas que cooperan.
En este relato biográfico Juan pone de manifiesto la vivencia que supone la llegada de una enfermedad aguda, que no se sabe bien cual es, que las pruebas, son todas negativas y que como un tren que le arrolla le va a llevar a las puertas de la muerte, pero en un último momento recibe un trasplante hepático y es como una explosión de la vida que comienza de nuevo. Resalta sus vivencias sobre la muerte, antes de este evento, durante el mismo y a posteriori. Relata su particular visión de la soledad en la UCI, de lo que puede ayudarte y de lo que no. Y ofrece su perspectiva en todo el proceso, de la actuación de los profesionales sanitarios, algunos amigos y conocidos, y otros desconocidos porque el relato tiene la singularidad de referirse a una persona que como Juan trabaja en el mundo sanitario, es auxiliar administrativo de un Centro de Salud. Los nombres de los personajes no son los reales, con el objeto de mantener el anonimato
Paciente varón, de 32 años de edad, que consulta por dolor en muñeca derecha. Tras meses en rehabilitación, se diagnostica “epicondilitis” y se indica tratamiento quirúrgico, se retira yeso a las 6 semanas, se observa color azulado de toda la piel del antebrazo y mano, con hiperhidrosis y mucho vello. Ante la sospecha, se solicita gammagrafía con Tc99 que confirma el diagnóstico de “Síndrome de Dolor Regional Complejo tipo I simpático dependiente en grado II-III”. Derivado a la Unidad del Dolor donde es sometido a múltiples tratamientos, se implantan electrodos corticales a nivel de duramadre en la Cisura de Rolando. Tras no obtener resultados y observarse fibrosis a nivel del cuello, se retiran los electrodos. Posteriormente, recibe tratamiento fisioterapeutico-osteópatico mejorando ostensiblemente. Al cabo de 3 meses, vuelve a hacer vida normal, reincorporándose a su puesto de trabajo habitual perdido hace 9 años.
Objetivo: identificar los elementos teóricos y metodológicos del cuidado que aplican los profesionales de enfermería en dos instituciones de salud del Departamento del Atlántico. Metodología: estudio descriptivo, transversal, la muestra estuvo conformada por 60 enfermeras de dos instituciones de salud. La obtención de datos se realizó a través de un cuestionario, consignándose las variables significativas, el análisis de los datos se calcularon en frecuencias absolutas y porcentajes. Resultados: predominó el grupo etario de 23 a 27 años: 43%, el género femenino: 100%, el 76% señalaron dificultades en la aplicación; Modelos de Enfermería orientadores de la práctica: Dorotea Orem: 78%; en la Aplicación de teorías Florence Nightingale: 73%, entre otros. Conclusión: Las enfermeras señalan que sí recibieron en el pregrado conocimientos sobre el tema, pero en la práctica algunas no los aplican; situación preocupante, debida a que no se reconoce la importancia de los principios científicos y filosóficos que orientan la profesión.
El implante coclear tiene cada vez mayor aplicación práctica en medicina. Diversos estudios demuestran los beneficios de una implantación más prematura. Explicaremos la ampliación de criterios de colocación, las nuevas pautas en preservación de audición residual, las nuevas técnicas quirúrgicas, las mejoras del material, farmacología y el papel de enfermería en dicho proceso. Objetivo principal: Recopilar los avances en conservación de audición residual y elaborar un protocolo de actuación para enfermería. Metodología: Búsqueda bibliográfica de artículos en PUBMED y CUIDEN. Tras una lectura crítica, se realizó una revisión de los mismos comparándolos con nuestra experiencia. Resultados principales: A mayor audición residual, los implantes cocleares obtienen mejores datos de audición. Conclusión principal: La conservación de la audición residual es capital en la mejora de la audición y enfermería juega un papel fundamental durante todo el proceso.
Rev Enferm;41(2): 102-110, feb. 2018. tab, ilus. [Artículo]
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