Conectar
by Carla Laria, Nicola Serra, Annarosa Trofa, Angelica Rodio, Giuseppe Chiarella, Pasquale Viola, Federica D’Ambrosio Geremicca, Emma Landolfi, Rita Malesci, Anna Rita Fetoni
IntroductionMathematical competencies are essential for both academic achievement and everyday functioning. Research investigating mathematical skills in deaf and hard of hearing (DHH) individuals has produced heterogeneous findings, indicating domain-specific performance patterns and the influence of linguistic and cognitive factors. Recent evidence further suggests that these differences may emerge early in development. This systematic review aims to evaluate mathematical competencies in DHH individuals and to contextualize their mathematical profile in relation to developmental dyscalculia.
MethodsA systematic review of observational studies was conducted in accordance with PRISMA 2020 guidelines. Studies were selected based on the PICOS framework, including participants under 18 years of age with congenital or acquired hearing loss. Comparisons involved hearing peers with or without specific learning disorders, and outcomes were based on direct assessments of mathematical abilities or related cognitive processes. A comprehensive literature search was performed in PubMed, Scopus, and Web of Science between March 31 and April 3, 2026, including all studies published up to the search date. In addition, relevant studies were identified through manual screening of reference lists. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Due to the heterogeneity of the included studies, results were synthesised narratively rather than through meta-analysis.
ResultsThe twelve included studies showed substantial variability in mathematical performance among DHH individuals. Lower achievement was more consistently observed in tasks with high linguistic demands, such as word problem solving, measurement, and mathematical reasoning, whereas procedural and visually supported tasks were relatively preserved. Evidence from both preschool and school-aged populations suggests that these differences may emerge early in development and remain observable across different developmental stages. Linguistic proficiency and access to a fully accessible language emerged as key factors associated with mathematical outcomes. Additional sources of variability included educational setting, communication modality, age of language acquisition, and hearing-related characteristics. Overall methodological quality was generally characterized by moderate methodological concerns, most commonly related to limited control of confounding variables, incomplete reporting of measurement validity, and small sample sizes.
ConclusionMathematical difficulties in deaf and hard of hearing (DHH) individuals appear to be domain-specific rather than global and appear to be associated with linguistic access and educational experiences. Evidence from both preschool and school-aged populations suggests that these differences may emerge early in development and remain evident across studies involving different age groups. These findings highlight the importance of considering language-related factors in both the assessment and instruction of mathematics in DHH learners.
Missed nursing care threatens quality and safety, but patient counts may not capture shift-level demands. We examined associations of patient-count and perceived workload indicators with missed care, separating within- and between-nurse effects.
A multicenter observational study using repeated shift-level measurements.
The study included 502 shift records from 213 nurses in 16 medical–surgical units across six Italian hospitals; the primary analysis included 480 records from 196 nurses. Patient-count indicators were nurse-reported numbers of assigned, isolated, and specialist-care patients; perceived workload included work rhythm/quantity, mental workload, emotional workload, and work organization. Grouped-binomial generalized estimating equations modeled the proportion of applicable activities missed, with nurse clustering, robust standard errors, exchangeable correlation, and hospital fixed effects. Workloads were decomposed into within- and between-nurse components, and four missed-care domains were examined.
Nurses reported a mean of 6.5 missed activities per shift; 29.9% of shifts had no missed care. The seven workload indicators were jointly associated with missed care (robust Wald χ 2[7] = 22.95, p = 0.002). Work rhythm/quantity was the only individual indicator with a nominal p-value below 0.05 (OR 1.24 per SD, 95% CI 1.03–1.49; p = 0.023), but it did not remain significant after Benjamini–Hochberg correction (q = 0.159). Assigned patient count was not clearly associated (OR 1.14, 95% CI 0.94–1.40; p = 0.192). In exploratory within–between analyses, the between-nurse work rhythm/quantity component was associated with missed care (OR 1.42, 95% CI 1.11–1.82; p = 0.005), whereas the within-nurse component was not (OR 1.03, 95% CI 0.90–1.17; p = 0.649). Domain-specific associations did not remain significant after multiplicity adjustment.
The workload indicators were jointly associated with missed nursing care, with secondary analyses indicating that the global signal was evident in the perceived-workload block. However, no individual workload indicator remained statistically significant after multiplicity adjustment. Work rhythm/quantity and its between-nurse component should therefore be regarded as exploratory signals requiring confirmation in studies with denser repeated measurements.
Workload surveillance research should evaluate patient-count and multidimensional perceived-workload indicators together. The present coefficient-specific findings are insufficient to support the operational use of work rhythm/quantity as a stand-alone workload indicator.
Progressive neurological disorders (PNDs) are life-limiting conditions with complex trajectories. PNDs require holistic, person-centred care that responds to the needs of both individuals and their families, including the provision of palliative and end-of-life (EOL) care.
This systematic review aimed to identify and synthesize existing international guidelines addressing palliative and EOL care in adult PND populations, with particular attention to their quality and scope.
We searched databases and gray literature sources for guidelines published between January 2013 and February 2026. Thirty-three guidelines were included for review. We appraised guidelines to assess quality and comprehensiveness against the World Health Organization's (WHO) domains of palliative care. We conducted inductive content analysis to identify key themes.
Guidelines predominantly were published from high-income countries and focused on dementia. Overall guideline quality was high. Most addressed physical, psychosocial, and social dimensions of care of the WHO domains; however, spiritual wellbeing was inconsistently addressed. Six interrelated themes emerged: (i) holistic symptom management; (ii) recognition of families and caregivers as partners in care; (iii) early and ongoing communication; (iv) value-aligned decision-making; (v) multidisciplinary team expertise; (vi) navigation of medicolegal complexities.
Findings indicate broad international consensus on the principles of high-quality palliative care in PND, while highlighting gaps in disease/diagnosis representation, spiritual care, and global equity. Future research could consider the importance of disease-specific guidelines, covering regions and countries from across a range of high-, middle-, and lower-income countries.
Clinicians caring for people with progressive neurological disorders can draw on the internationally consistent principles identified in this review including early integration of palliative care, proactive and open communication, and recognition of families as partners in care to benchmark and strengthen their practice. Gaps in spiritual wellbeing, condition-specific guidance, clinical supports, and equitable access represent clear targets for workforce education, service development, and health policy advocacy.
This study evaluated district-wide implementation of a digital wound model of care combining an artificial intelligence–enabled application with a virtual command centre across four hospitals and five community health centres in Australia. A post-implementation multimethods evaluation (January 2024–January 2026) of patients (n = 94), frontline clinicians (n = 75), and senior wound nurses (n = 9) and a product manager (n = 1) using surveys, semi-structured interviews and analysis of governance meeting minutes. Patient satisfaction was high: 91% rated care as ‘excellent’ or ‘good’, 93% 'agreed' or 'strongly agreed' it was effective and 96% 'agreed' or 'strongly agreed' that they felt confident in the care they received from their wound care provider. Just over half (59%) felt they were meaningfully involved in decisions about their own care, an area identified for targeted improvement in future iterations of the model. The most cited virtual care benefits included improved condition understanding (63%), and reduced travel (49%). Among the 28 patient app users, 89% reported improved communication between them and the wound care provider and 79% self-management confidence. Senior wound nurses rated the app highly for ease of use and continuity of care (both 86%), but poor connectivity was a limitation. Frontline clinicians valued enhanced documentation consistency but reported barriers including time pressures and training burden. This multisite implementation demonstrates that digital wound care models are highly acceptable and deliver perceived clinical benefit, while identifying patient involvement in decision-making and clinician workflow integration as priority areas for future investment.
by Oliver Mendoza-Cano, Xóchitl Trujillo, Mónica Ríos-Silva, Jaime Alberto Bricio-Barrios, Agustin Lugo-Radillo, Rosa Tapia-Vargas, Jesús Venegas-Ramírez, Eder Fernando Ríos-Bracamontes, Herguin Benjamin Cuevas-Arellano, Yolitzy Cárdenas, Raúl Aquino-Santos, Iris Anecxi Jiménez-Vieyra, Juan Manuel Uribe-Ramos, Verónica Benites-Godínez, Teresa Evangelina Martínez-Díaz, Mario López-Rojas, Annel García-Solórzano, Efrén Murillo-Zamora
BackgroundMexico has experienced escalating dengue transmission driven by the co‑circulation of four antigenically distinct serotypes (DENV‑1 through DENV‑4). Multi‑serotype transmission is epidemiologically relevant, yet its spatiotemporal patterns at sub‑national resolution remain poorly characterized.
MethodsWe analyzed 103,426 PCR‑confirmed, serotyped dengue cases across 1,547 of 2,471 Mexican municipalities from January 2020 to December 2025. Kulldorff’s space‑time scan statistic under a discrete Poisson model was applied independently to each serotype and to all serotypes combined. Co‑circulation was defined as the spatiotemporal overlap of significant clusters from at least two serotypes within the same municipality for ≥ 1 epidemiological week.
ResultsWe identified 159 statistically significant clusters across all serotypes combined. DENV‑3 was dominant (64.4% of cases; annual incidence 59.9/100,000), consistent with the reemergence of a long‑absent serotype. The 2024–2025 season produced a nationally synchronized epidemic across geographically distant regions. Co‑circulation of at least two serotypes occurred in 1,545 municipalities; 217 experienced simultaneous clustering of all four serotypes. Active co‑circulation was present in 275 of 311 study weeks. Mean pairwise temporal overlap ranged from 8.0 to 12.0 weeks, with maximum overlaps of 29–30 weeks.
ConclusionsFour‑serotype co‑circulation was documented at municipal resolution, concentrated in the Gulf coast, the Yucatán Peninsula, and northeastern Mexico. The 217 municipalities with simultaneous clustering of all four serotypes may represent areas of epidemiological interest for further investigation. This municipality‑level spatiotemporal framework offers operationally relevant resolution for tracking multi‑serotype activity and supporting serotype‑aware dengue monitoring at sub‑national scale.
Analyse the meaning of conscientious objection to euthanasia and/or physician-assisted suicide from the perspective of health professionals, students, patients, family members and regulations.
Qualitative systematic review. This review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
The Joanna Briggs Institute Critical Appraisal Checklist was used to evaluate the included articles. Data were extracted and analysed using meta-aggregation.
The CINAHL, PubMed, PsycINFO, Web of Science and Scopus databases were consulted between January and April 2024. The protocol was registered in PROSPERO (ID: 1007658).
We analysed 15 articles, mainly published between 2019 and 2023, from Canada, Australia, the United States, Spain, and the Netherlands. Two main findings were identified: non-moral motivations (perceived competence, social context, and emotional reactions) and moral motivations (ethical principles, moral consciousness, and religious beliefs).
Conscientious objection is a complex phenomenon in which moral, emotional, and organisational factors converge. Differentiating between moral and non-moral motivations is essential to understanding this diversity of reasons for conscientious objection and avoiding oversimplifications. Clear institutional frameworks are needed to facilitate the handling of objections, balance the rights of professionals and patients, and foster a culture of ethical dialogue.
Healthcare professionals, patients, and families need clear tools and criteria to manage conscientious objection related to euthanasia and physician-assisted suicide. The findings can contribute to the creation of precise institutional guidelines on the referral procedure and mechanisms that ensure a balance between rights and duties.
This meta-synthesis provides an integrated view of conscientious objection from multiple perspectives. The results contribute to a better understanding of the ethical complexity of conscientious objection and the practical implications for health systems that are in the process of implementing euthanasia and medically assisted dying laws.
PRISMA.
No patient or public contribution.
To map existing scientific evidence on the relationship between clinical supervision and burnout and burnout-related outcomes among nurses in clinical practice.
Scoping review.
The review followed the Joanna Briggs Institute methodology for scoping reviews. A total of 1396 records were identified and imported into Rayyan for screening. Data were synthesised descriptively using absolute and relative frequencies and presented in narrative and tabular form.
Searches were conducted in February 2025 in CINAHL Complete, Nursing & Allied Health Collection: Comprehensive, MedicLatina, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PubMed, and Web of Science Core Collection. Grey literature was searched in OpenGrey and the Portuguese Open Access Scientific Repository (RCAAP). No time or language restrictions were applied.
Twenty studies were included. The evidence base was heterogeneous and predominantly cross-sectional. Clinical supervision in Nursing (CSN) was mainly delivered face-to-face and most frequently in group formats, with considerable variability in frequency, duration and theoretical grounding. Burnout was primarily assessed using validated instruments, particularly the Maslach Burnout Inventory. Nine studies reported inverse statistical associations between CSN and burnout or burnout-related outcomes.
Clinical supervision is frequently associated with burnout and burnout-related indicators among nurses. Clearer intervention reporting, stronger theoretical grounding, and research designs capable of exploring temporal and contextual dynamics are needed to advance the field.
Clinical supervision may represent a context-sensitive organisational support strategy within broader workforce well-being frameworks, particularly when structurally defined and supported by leadership.
This review clarifies how clinical supervision has been conceptualised and evaluated, identifying reporting gaps and priorities for future research.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review.
No stakeholder consultation was undertaken. Future research should consider involving practising nurses and supervisors to define core CSN components.
Trial Registration: The protocol was registered in the Open Science Framework
Introducción:
El artículo examina la trayectoria histórica de la Escuela Oficial de Matronas de Santa Cristina en Madrid, fundada en 1917. Este centro fue pionero en la profesionalización de la enfermería obstétrica en España, contribuyendo de manera significativa a la formación de matronas y a la mejora de la salud materno-infantil.
Objetivo:
El propósito del estudio es analizar los hitos más relevantes en la evolución de la Escuela Oficial de Matronas de Santa Cristina, evaluando su impacto en la formación sanitaria y la implementación de políticas de salud pública en España.
Metodología:
Se utilizó una revisión documental basada en fuentes históricas, archivos institucionales y literatura académica. Se describieron los aspectos clave de su fundación, desarrollo, reformas educativas y su posterior integración al sistema universitario.
Resultados:
El análisis destaca cómo la Escuela, vinculada a la Maternidad de Santa Cristina, brindó una formación avanzada y práctica en obstetricia, incorporando avances científicos y tecnológicos a lo largo de su existencia. Enfrentó desafíos derivados de cambios políticos, presupuestarios y educativos. Su integración al sistema universitario en el siglo XX consolidó su prestigio, garantizando la continuidad de su legado.
Conclusiones:
La Escuela Oficial de Matronas de Santa Cristina complementó un papel fundamental en la modernización de la obstetricia en España. Su contribución a la formación de profesionales y al fortalecimiento de la salud pública sigue siendo un referente histórico en la educación y práctica de los cuidados materno-infantiles.
Objetivo: conhecer a percepção do paciente ao revelar o diagnóstico de HIV/AIDS para os familiares.
Metodologia: Trata-se de um estudo do tipo descritivo com abordagem qualitativa realizado nos meses de maio a junho de 2017, em um ambulatório de um hospital do município de Fortaleza, Ceará – Brasil, o qual possui atendimento especializado em IST/HIV/AIDS. Para a coleta de dados, utilizou-se um roteiro semi estruturado e a análise dos dados foi feito a partir conteúdo temática de Minayo (2007). O estudo foi aprovado pelo Comitê de Ética em Pesquisa da referida instituição (CEP193/2009).
Resultados: As categorias que surgiram foram: “A escolha para quem irá contar”; “Reação dos familiares com a revelação do diagnóstico”; “Sentimentos após a revelação do diagnóstico” e “Benefícios vivenciados com a revelação do diagnóstico”. Verificou-se que a revelação diagnóstica representou uma facilitação na adesão ao tratamento e o apoio psicológico no convívio familiar.
Conclusão: A maioria dos participantes se sentiu mais segurança em revelar o seu diagnóstico para um membro familiar como pai, mãe, irmão ou companheiro, apesar do medo das mudanças que poderiam ser causadas devido a essa revelação como preconceito, não aceitação, abandono, depressão, tristeza, medo de transmissão e morte.
To assess the relationship between the structural position of individuals within their village network and symptoms of depression and postpartum depression, among men and women.
Community-based, observational, cross-sectional study.
176 villages in the Copan region of Honduras.
Village residents, comprising 25 605 adults surveyed in a census-based study; using data collected between October 2015 and December 2019.
Symptoms of depression and postpartum depression, among men and women.
Across all participants, 34.99% reported depression symptoms (40.50% for women and 27.62% for men). Among recent parents with a new child in the last 6 months, 28.89% reported postpartum depression symptoms (31.29% for women and 24.31% for men). Women with higher social intransitivity (ie, a greater proportion of friend-pairs among their friends that were not themselves connected) had higher odds of depression symptoms (OR=1.27, 95% CI 1.14 to 1.41), an association not found for men nor in postpartum parents. Because this coefficient is estimated on a 0–1 scale, it corresponds to approximately 2.4% higher odds of depression per 10 percentage-point increase in social intransitivity. In a signed-network decomposition that also included adversarial ties, only the proportion of incomplete/no-tie friend-pairs was associated with depression in women (OR=1.03, 95% CI 1.01 to 1.04), corresponding to approximately 3% higher odds of depression per 10 percentage-point increase.
We report that structural social network position and connectedness beyond dyadic ties, including the friendships and adversarial ties of a person’s friends, are associated with depression. These findings highlight the importance of linking psychological health to broader social connections in the context of face-to-face relationships.
To analyse the completeness of the COVID-19 vaccination schedule and identify factors associated with vaccine uptake.
Cross-sectional study.
Data were collected through face-to-face interviews conducted in all 26 Brazilian state capitals and the Federal District between 2022 and 2023, using a sequential sampling approach.
A total of 1392 individuals aged 18 years or older experiencing homelessness for at least 6 months were included.
The primary outcome was the completeness of the COVID-19 vaccination schedule (complete vs incomplete), based on self-reported vaccination status. Secondary analyses examined sociodemographic, institutional and behavioural factors associated with vaccine uptake using binary logistic regression.
Completion of the vaccination schedule was positively associated with receiving government aid (OR: 1.58; 95% CI 1.09 to 2.30), visits from street clinic health agents (OR: 3.19; 95% CI 1.95 to 5.36), prior COVID-19 diagnosis (OR: 5.77; 95% CI 3.17 to 11.15), support for mandatory vaccination (OR: 3.76; 95% CI 2.48 to 5.76), trust in vaccine efficacy (OR: 3.92; 95% CI 2.63 to 5.89), seeking information from community sources (OR: 1.91; 95% CI 1.01 to 3.88) and trust in federal authorities (OR: 1.57; 95% CI 1.06 to 2.31).
This study identified structural, social and individual factors associated with complete COVID-19 vaccination among people experiencing homelessness in Brazil. Although overall coverage was substantial, gaps in vaccination completeness persisted. Social support, healthcare outreach and trust in vaccines were associated with higher uptake, highlighting important barriers and facilitators to vaccination in socially vulnerable populations.
Poststroke depression (PSD) affects approximately 33% of stroke survivors and is associated with worse outcomes, poor quality of life (QOL) and mortality. Despite its prevalence and consequences, there is no consensus on the most effective strategy for PSD prevention. Behavioural activation (BA) is an effective intervention for depression across diverse populations and is considered safer, better tolerated and a longer-lasting alternative to antidepressant medications. This study aims to test the effectiveness of a remotely delivered BA intervention to prevent PSD (Tele-BA-S).
We will conduct a randomised effectiveness trial of 350 low-income adults (≥ 55 years) within 3 months of ischaemic or haemorrhagic stroke and with subthreshold depression (Patient Health Questionnaire-9 score
Ethical approval was obtained by the University of Texas Health Science Center at Houston’s (UTHealth Houston) Committee for the Protection of Human Subjects Institutional Review Board. The trial protocol, statistical analysis plan and code, and deidentified participant data will be made available via the National Institute of Mental Health Data Archive. The results will be presented at academic conferences and submitted for publication. The authors declare that they have no conflicts of interest relevant to the content of this manuscript.
by Patricia Fiorino, Luigi Fernandes Rosa Cauduro, Danielle Silberspitz Konig, Leonardo Fernandes Rosa Cauduro, Caio de Araujo Santos, Juliana Alves Kavai, Isadora Durigan Duarte, Anna Laura Viacava Américo
Zebrafish (Danio rerio) are widely used as models in cardiovascular research due to their rapid development, optical transparency, and genetic similarity to humans. However, the lack of standardized experimental conditions, particularly regarding developmental stage and microenvironmental parameters, limits reproducibility across studies. This study aimed to characterize cardiovascular function in Zebrafish larvae and evaluate the impact of developmental stage and environmental factors. Wild-type AB embryos were maintained under standard conditions, and heart rate (HR), cardiac output (CO), and ejection fraction (EF) were measured at 24, 30, 48, 52, 56, 72, 78, and 80 hours post-fertilization (hpf). The effects of variations in temperature (27.0, 27.5, and 28.0 °C) and pH (7.0, 7.4, and 8.0) were also assessed. Results showed a progressive increase in HR from 24 to 72 hpf, stabilizing thereafter. CO exhibited two phases of elevation: an early rise between 24–48 hpf and a stronger increase between 48–56 hpf. EF remained generally stable, with a transient reduction at 48 hpf. Cardiovascular performance reached a physiologically stable state after 72 hpf, defining a reliable window for functional studies. Environmental conditions modulated these parameters: temperature variation induced approximately 20% difference in HR and reduced EF, while CO was minimally affected. In contrast, pH variations within the physiological range had no significant impact on HR, CO, or EF. These findings highlight developmental and environmental variables that may influence cardiovascular measurements in Zebrafish larvae and support the development of more consistent experimental approaches in cardiovascular and toxicological research.Primary progressive aphasia (PPA) is a neurodegenerative syndrome associated with Alzheimer’s disease and frontotemporal degeneration. Non-invasive brain stimulation (NIBS) is a promising treatment, especially associated with language therapy, but comparative efficacy and long-term effects between the different techniques (transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS)) remain unknown. The present study aims to investigate the effects of non-invasive brain stimulation, alone or associated (tDCS/TMS/tDCS plus TMS) combined with language therapy delivered during a period of 6 months, in the progression of language impairment in PPA, compared with sham stimulation combined with language therapy.
The study is a randomised, double-blinded, parallel, sham-controlled clinical trial. Patients with PPA in early stages (global Clinical Dementia Rating equal to or less than 1) are eligible. They are to be randomised to one of the four treatment arms of the study (active tDCS-active TMS, active tDCS-sham TMS, sham tDCS-active TMS, sham tDCS-sham TMS). All patients will receive language therapy immediately after each session of NIBS, for 6 months. The primary outcome is the Mini-Linguistic State Examination. The secondary outcomes are naming of trained items, Addenbrooke’s Cognitive Examination, Interview for Deterioration in Daily Living Activities, Clinical Dementia Rating including behaviour and language domains, Neuropsychiatric Inventory and regional brain metabolism. Exploratory substudies will be conducted including blood biomarkers, quantitative electroencephalography and spontaneous speech assessment.
The study is registered (ClinicalTrials.gov: NCT07158216) and approved by the Ethics Committee of the Hospital Clinico San Carlos (code 25/309-IC_P_CE). Patients will be enrolled after signing an informed consent form. Study outcomes will be disseminated through presentations at scientific conferences, publications in peer-reviewed journals and other academic forums.
To examine and map the available literature on outcomes associated with interventions carried out by advanced practice nurses in chronic wound care.
The role of the advanced practice nurses in wound care is identified as a key element in the management of patients with chronic wounds. However, the literature offers fragmented knowledge of the outcomes associated with their practice.
Scoping review.
This scoping review was conducted following the methodological framework proposed by Arskey and O'Malley, following the Preferred Reporting Item for Systematic Review and Meta-analysis for Scoping Review. PRISMA-ScR Checklist is included in the manuscript. Observational or experimental studies related to patients affected by chronic wounds and cared for by advanced practice nurses in wound care were included.
The following databases were queried: PubMed, CINAHL, Cochrane Library, and Scopus from 01 May 2025 to 31 October 2025.
The search strategy in the consulted databases identified 1956 studies; 31 met the inclusion criteria. Different types of chronic wounds were investigated: diabetic foot ulcers, venous leg ulcers, and pressure injuries. The most frequently measured outcomes were clinical responses (healing, recurrence, complications), organizational efficiency (referrals, resource utilization), and patient-reported outcomes.
Evidence from the included studies suggests that Advanced practice nurses led wound care models may be associated with faster healing, lower recurrence and complication rates, and more efficient care pathways, across different settings. This review highlights the global applicability of APN-led models, showing consistent improvements in clinical, organizational, and patient-reported outcomes through core interventions.
This scoping review follows Arskey and O'Malley's methodological framework and the Preferred Reporting Item for Systematic Review and Meta-analysis for Scoping Review.
No Patient or Public Contribution.
The revision protocol was registered on the OSF (https://doi.org/10.17605/OSF.IO/P9TA4).
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 map factors influencing nurses' engagement in clinical mentorship in nursing education and explore their interactions using network analysis.
Observational cross-sectional study employing an online survey from July 2024 to May 2025.
A total of 261 clinical mentors from healthcare institutions in Catalonia, Spain, completed the survey. Key variables included engagement in clinical mentorship (implication, motivation, satisfaction, compromise), perceived obstacles, ward manager support, emotional intelligence, emotional wellbeing, working and employment conditions. Data were analysed using regularized partial correlation network analyses. Centrality indices were calculated to determine the most influential variables within the network structure.
Motivation, ward manager support, and emotional intelligence emerged as the most central, interconnected drivers of engagement. Motivation showed positive associations with commitment and implication in the mentoring role and a negative association with perceived obstacles. Ward manager support was linked to emotional wellbeing and peer support, reflecting the importance of psychosocial resources. Emotional intelligence appeared to support motivation, work control, and satisfaction with the mentoring role. In contrast, professional experience and employment conditions showed limited influence within the network.
This study provides a comprehensive understanding of how multiple factors interact to shape nurses' engagement in clinical mentorship. Motivation, ward manager support, and emotional intelligence represent key leverage points for strengthening mentorship practices.
Sustainable, high-quality clinical practicums require supportive work environments that recognize and foster mentors' intrinsic motivation, leadership support, and emotional skills.
Clinical mentors are essential to student learning, and so is their engagement in the mentoring role. This study is the first to apply network analysis to this process, revealing that motivation, emotional intelligence, and ward manager support are central to engagement, while professional experience and employment conditions are less relevant. These findings can guide institutional strategies to promote supportive and nurturing clinical learning environments.
The manuscript is based on the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).
This study did not include patient or public involvement in its design, conduct, or reporting.
To explore the enablers of and barriers to implementing advanced practice nursing in primary health care in Germany and Brazil.
A qualitative cross-country comparative study.
Nine focus groups were conducted: 4 in Brazil and 5 in Germany with 48 participants (23 primary health care policy stakeholders and 25 nurses practicing in primary health care and general practitioners) between May 2022 and June 2023. The data were analysed by content analysis using a deductive–inductive approach.
Our findings reveal a need for clarity around the concept, specific roles and responsibilities of advanced practice nurses in primary health care. Although there is still no regulation in place for practising advanced practice nursing in either country, clear drivers can be observed, with Germany strengthening community health nursing and Brazil following clinical protocols in nursing practice. Dialogue among stakeholders—at both the policy and practitioner levels—is essential to bridge communication gaps. Additionally, involving patients in the implementation process is crucial for the holistic integration of advanced nursing roles.
Political, organisational and financial barriers persist, such as the need to establish both legal foundations and regulatory frameworks, enhance political participation within the nursing profession, and involve stakeholders in dialogue and consensus-building efforts. Giving advanced practice nursing a higher priority on political and research agendas—with policy adjustments and input from practitioners—can help integrate advanced practice nursing into primary health care.
Our findings highlight that actively involving nursing as an equal partner in political discourse is seen by stakeholders as crucial to drive the implementation process forward sustainably.
This study addresses the lack of data on the enablers and barriers to implementing advanced practice nursing in primary health care in Germany and Brazil. It underscores the need for clearer definitions of advanced practice nursing in primary health care, as well as sufficient regulation and funding. Dialogue is essential to bridge gaps and foster mutual understanding. The findings support future practice development and research, especially in countries that have introduced advanced nursing practice roles in primary health care.
The COnsolidated criteria for REporting Qualitative research (COREQ).
No involvement of patient and public contribution.
Our study highlights the growing adoption of expanded nursing responsibilities even in countries that have not yet formally implemented advanced practice nursing roles.
by Víctor Herrera, María Consuelo Miranda, Anyela Lozano-Parra, Diana Niño, Luis Ángel Villar, Rosa Margarita Gélvez Ramírez, Thomas Jaenisch, Laura Pezzi, Claudia Acevedo, Jürg Niederbacher
BackgroundZika virus (ZIKV) infection has been inconsistently associated with neurodevelopmental delay (ND). We aimed to compare the incidence of ND between ZIKV-exposed and ZIKV-unexposed children within the ZIKAlliance (ZA) cohort, in Colombia, assessed 2 years after birth (2018–2021).
MethodsWe performed a neurodevelopmental evaluation on normocephalic children (aged 40–72 months) from the ZIKAlliance cohort. Children were classified as ZIKV-exposed (maternal positive RT-qPCR or virus neutralization test – VNT) or unexposed (maternal negative IgG ELISA or VNT in paired antenatal samples). A trained psychologist, blinded to exposure status, administered the Denver Developmental Screening Test II (DDST-II). Children were considered at ND risk if they presented ≥1 delay or ≥2 cautions in one or more areas, within their age range in the DDST-II scale. Inconclusive initial tests were re-evaluated. Adjusted odds ratios were estimated using logistic regression.
ResultsWe analyzed conclusive DDST-II results from 153 children (mean age: 4.7 years; 53.8% male). Overall, 57.2% (n = 83) were classified as cases of ND. Children with ND were more likely to be male (61.4% versus 43.5%) and less likely to attend daycare or school (42.2% versus 11.3%) than children with normal development. After adjusting for child age, sex, household size, and education, the association between in utero ZIKV exposure and ND was not statistically significant (OR = 0.71; 95% CI: 0.32–1.59, p = 0.320). However, children attending daycare or school had a significantly lower risk of ND compared to those who stayed at home.
ConclusionsPrenatal ZIKV exposure was not associated with ND in this cohort of normocephalic preschool children. Instead, attending a community daycare or school emerged as a significant protective factor against developmental delays.
FreshRSS 