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Background When healthcare students witness, engage in, or are involved in an adverse event, it often leads to a second victim experience, impacting their mental well-being and influencing their future professional practice. This study aimed to describe the efforts, methods, and outcomes of interventions to help students in healthcare disciplines cope with the emotional experience of being involved in or witnessing a mistake causing harm to a patient during their clerkships or training. Methods This systematic review followed the PRISMA guidelines and includes the synthesis of eighteen studies, published in diverse languages from 2011 to 2023, identified from the databases MEDLINE, EMBASE, SCOPUS and APS PsycInfo. PICO method was used for constructing a research question and formulating eligibility criteria. The selection process was conducted through Rayyan. Titles and abstracts of were independently screened by two authors. The critical appraisal tools of the Joanna Briggs Institute was used to assess the risk of bias of the included studies. Results A total of 1354 studies were retrieved, 18 met the eligibility criteria. Most studies were conducted in the USA. Various educational interventions along with learning how to prevent mistakes, and resilience training were described. In some cases, this experience contributed to the student personal growth. Psychological support in the aftermath of adverse events was scattered. Conclusion Ensuring healthcare students’ resilience should be a fundamental part of their training. Interventions to train them to address the second victim phenomenon during their clerkships are scarce, scattered, and do not yield conclusive results on identifying what is most effective and what is not.

Uterine microbiota may be involved in reproductive health and disease. This study aims to describe and compare the vaginal and endometrial microbiome patterns between women who became pregnant and women who did not after in vitro fertilization. We also compared the vaginal and endometrial microbiome patterns between women with and without a history of repeated implantation failures (RIF). This pilot prospective cohort study included 48 women presenting to the fertility clinic for IVF from May 2017 to May 2019. Women who achieved clinical pregnancy presented a greater relative abundance of Lactobacillus spp. in their vaginal samples than those who did not (97.69% versus 94.63%; p = 0.027. The alpha and beta diversity of vaginal and endometrial samples were not statistically different between pregnant and non-pregnant women. The Faith alpha diversity index in vaginal samples was lower in women with RIF than those without RIF (p = 0.027). The alpha diversity of the endometrial microbiome was significantly higher in women without RIF (p = 0.021). There were no significant differences in the vaginal and endometrial microbiomes between pregnant and non-pregnant women. The relative abundance of the genera in women with RIF was different from those without RIF. Statistically significant differences in the endometrial microbiome were found between women with and without RIF.

Background Pandemics such as COVID-19 pose threats to the physical safety of healthcare workers and students. They can have traumatic experiences affecting their personal and professional life. Increasing rates of burnout, substance abuse, depression, and suicide among healthcare workers have already been identified, thus making mental health and psychological wellbeing of the healthcare workers a major issue. The aim of this systematic review is to synthesize the characteristics of emotional support programs and interventions targeted to healthcare workers and students since the onset of COVID-19 and other SARS-CoV pandemics and to describe the effectiveness and experiences of these programs. Method This was a mixed method systematic review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the review was registered on PROSPERO [CRD42021262837]. Searches were conducted using Medline, CINAHL, PsycINFO, Cochrane Library, and Scopus databases. The COVIDENCE systematic review management system was used for data selection and extraction by two independent reviewers. The JBI (Joanna Briggs Institute) critical appraisal tools were used to assess the quality of selected studies by two additional reviewers. Finally, data extraction and narrative analysis were conducted. Results The search retrieved 3161 results including 1061 duplicates. After screening, a total of 19 articles were included in this review. Participants in studies were nurses, physicians, other hospital staff, and undergraduate medical students mostly working on the front-line with COVID-19 patients. Publications included RCTs ( n  = 4), quasi-experimental studies ( n  = 2), cross-sectional studies ( n  = 6), qualitative interview studies ( n  = 3), and systematic reviews ( n  = 4). Most (63.4%) of the interventions used online or digital solutions. Interventions mostly showed good effectiveness (support-seeking, positive emotions, reduction of distress symptoms etc.) and acceptance and were experienced as helpful, but there were some conflicting results. Conclusion Healthcare organizations have developed support strategies focusing on providing emotional support for these healthcare workers and students, but it is difficult to conclude whether one program offers distinct benefit compared to the others. More research is needed to evaluate the comparative effectiveness of emotional support interventions for health workers.

To explore speaking up behaviours, barriers to openly expressing patient safety concerns, and perceived psychological safety climate in the clinical setting in which healthcare trainees from Ibero-America were receiving their practical training. Cross-sectional survey of healthcare trainees from Colombia, Mexico, and Spain (N = 1,152). Before the field study, the Speaking Up About Patient Safety Questionnaire (SUPS-Q) was translated into Spanish and assessed for face validity. A confirmatory factor analysis was conducted to establish the construct validity of the instrument, and the reliability was assessed. The SUPS-Q was used to evaluate voice behaviours and the perceived psychological safety climate among Ibero-American trainees. Descriptive and frequency analyses, tests for contrasting means and proportions, and logistic regression analyses were performed. Seven hundred and seventy-one trainees had experience in clinical settings. In the previous month, 88.3% had experienced patient safety concerns, and 68.9% had prevented a colleague from making an error. More than a third had remained silent in a risky situation. Perceiving concerns, being male or nursing student, and higher scores on the encouraging environment scale were associated with speaking up. Patient safety concerns were frequent among Ibero-American healthcare trainees and often silenced by personal and cultural barriers. Training in speaking up and fostering safe interprofessional spaces is crucial.

Objectives: This study aimed to evaluate gender-based disparities in preventable adverse events due to low-value practices (LVPs) in primary care. Methods: A retrospective cohort study in Alicante, Spain. Results: A total of 1,516 patient records were examined, finding that older individuals and women experienced more LVP-related events. Female patients faced a higher volume of such events than males with the same health issue. Interaction analysis revealed patients treated by male physicians had more severe events, while those attended by females experienced milder ones. Adverse events were more frequent in LVPs associated with gender-based reasons. Conclusion: These results highlight the need for tailored healthcare professional awareness programs on overuse’s impact on safety. Addressing outcome differences between male and female patients should inform awareness campaigns.

Purpose This study aimed to identify the perceptions and attitudes of pediatricians and parents/caregivers regarding medication errors at home, and to compare the findings from the two populations. Methods This was a cross-sectional survey study. We designed a survey for working pediatricians and another one for parents or caregivers of children aged 14 years and younger. The survey’s questions were designed to assess provider and parental opinions about the difficulty faced by parents providing medical treatment, specific questions on medication errors, and on a possible intervention program aimed at preventing pediatric medication errors. Pediatrician and parent responses to matching questions in both surveys were compared. Results The surveys were administered in Spain from 2019 to 2021. In total, 182 pediatricians and 194 families took part. Most pediatricians (62.6%) and families (79.3%) considered that managing medical treatment was not among the main difficulties faced by parents in caring for their children. While 79.1% of pediatricians thought that parents consulted the internet to resolve doubts regarding the health of their children, most families (81.1%) said they consulted healthcare professionals. Lack of knowledge among parents and caregivers was one of the causes of medication errors most frequently mentioned by both pediatricians and parents. Most pediatricians (95.1%) said they would recommend a program designed to prevent errors at home. Conclusions Pediatricians and families think that medical treatment is not among the main difficulties faced by parents in caring for their children. Most pediatricians said they would recommend a medication error reporting and learning system designed for families of their patients to prevent medication errors that might occur in the home environment.

Background Adherence to statin therapy is crucial for reducing the recurrence of cardiovascular events. Numerous methods exist to measure medication adherence, including those based on prescription data, patient self-report, medication counting, and direct methods. It is important to determine which of these methods are appropriate for use in clinical practice. This systematic review aimed to identify the methods used to measure adherence and persistence to statins in patients undergoing cardiovascular secondary prevention and to evaluate the validity indicators of these methods. Methods This systematic review included studies reporting methods to measure adherence and/or persistence to statins in cardiovascular secondary prevention. Medline, Embase, and Scopus databases were searched from inception to February 2025. Rayyan was used for the study selection and extraction data processes. Validity indicators of the adherence/persistence methods were collected; it was reported. Risk of bias of studies reporting the method validity was evaluated using the COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) tool. Results A total of 77 studies were included. Regarding adherence measurement, the most frequently used method was prescription refill records ( n  = 55) and self-report methods ( n  = 20). Electronic monitoring methods ( n  = 2), self-perceived adherence by physician ( n  = 1), and pill counting ( n  = 1) were less frequently used methods. Direct methods, using HPLC–MS/MS, were used in combination with other indirect methods ( n  = 5). For measuring persistence, prescription refill records were the predominant method ( n  = 9), while self-report methods were used in three studies, and one study used a standardized questionnaire. Several of the indirect methods have validity indicators for measuring adherence in different study populations and to different medications. Only one study provides validity indicators for the MAT questionnaire specifically adapted for statins. Conclusions The methods for measuring adherence to statins in secondary cardiovascular prevention were predominantly indirect, relying on prescription and supply records and self-report methods. Pill counting, electronic monitoring, and direct measurement via LC–MS/MS were less commonly used. Persistence was primarily measured through prescription refill records. None of the indirect methods was validated; thus, their use for measuring adherence to statins is not recommended. There is a need for new validated tools, incorporating a gender perspective, to measure adherence to statins in this population. Systematic review registration PROSPERO CRD42023463981.

Published evidence on the progress of occupational therapy research from a broad perspective is limited. The purpose of this study was to analyze the international research productivity on occupational therapy from 1917 to 2020. This was a bibliometric study including articles indexed on MEDLINE, Scopus, and CINAHL. The literature search was conducted in June 2021 using the descriptor “occupational therapy” and the term “Ergotherap*”, and was limited to citable documents. Price’s law and Bradford’s law were applied to analyze a number of bibliometric indicators. Research on occupational therapy had an average annual growth rate of 26.4% and followed an exponential model. The top producing countries were the USA (21.52%) and the UK (6.07%). There is a high transience index of 74.81%. The top producing author was Kielhofner, G. (n = 132). Studies with the highest reported scientific evidence accounted for 1.13% (n = 638) of the total number of publications. More randomized controlled trials are necessary to increase the quality of the evidence base. Moreover, a greater collaboration between authors is needed for the professionalization of this research field.

Background Diabetic peripheral neuropathy (DPN) is a common and serious complication of diabetes mellitus, affecting sensory, motor, and autonomic nerves. It increases the risk of foot ulceration and falls. Management typically involves preventive strategies like patient education, risk stratification, and regular foot screenings. Exercise plays a key role in enhancing glycemic control and nerve function, reducing the risk of DPN and related complications. This umbrella review aimed to evaluate the impact of different exercise interventions on patients with DPN. Methods The search was conducted in the following databases: Pubmed, Scopus, Cochrane Library, Embase, and SPORTDiscus, from the establishment of the database up to the search date (September 11, 2023). We included systematic reviews and meta-analyses assessing exercise interventions in adults with type 1 or type 2 diabetes and DPN. Studies were selected based on predefined PICO criteria. The methodological quality of included reviews was assessed using the AMSTAR-2 tool. Results were synthesized narratively and categorized by exercise type and health outcome. Results Fourteen reviews were included, examining the effects of various exercise interventions. Duration ranged from one week to 12 months, and studies were conducted in multiple countries. Additionally, we extracted and reanalyzed individual results from 70 primary studies included within the reviews. Some meta-analyses reported significant improvements in fasting glucose and HbA1c (n = 1), neuropathic symptoms (n = 3), physical function (n = 1), static and dynamic balance (n = 2), range of motion (n = 1), and fear of falling (n = 1). No significant effects were found for BMI, ulcer incidence, adverse events, weight-bearing activity, quality of life, or forefoot plantar pressure (n = 1). Outcome assessment tools included the Biodex system (n = 9), single-leg stance (n = 8), Berg Balance Scale (n = 11), and Timed Up and Go (n = 13) for balance; nerve conduction velocity (n = 8), MNSI (n = 6), and Total Symptom Score (n = 3) for nerve function; fasting glucose (n = 3) and HbA1c (n = 5) for glycemic control. Other outcomes included muscle strength (n = 6), functional capacity (n = 6), pain (n = 6), and quality of life (n = 6). Conclusions Exercise training appears to have potential benefits for certain aspects of DPN, neuropathic symptoms, and functional capacity. However, the effects on glycemic control, fall risk reduction, and ulcer prevention remain inconclusive, with significant variability in study outcomes. Key points Exercise interventions, including aerobic, resistance, and balance training, show beneficial effects on neuropathic symptoms, nerve conduction, glycemic control, and postural stability in patients with diabetic peripheral neuropathy. Combined aerobic and resistance training appears more effective than single-mode interventions in reducing HbA1c and improving metabolic outcomes The substantial heterogeneity in study designs and exercise protocols underscores the need for standardized, evidence-based exercise guidelines tailored to this population

Background and Objectives: The purpose of this retrospective population-based cohort study was to analyse the association between attendance of physiotherapy with mortality in the Spanish general population and describe the profile of people who do not visit a physiotherapist in Spain. Material and Methods: The data sources were the 2011/2012 National Health Survey (ENSE11) and the national database of death in Spain, and the participants were all adult respondents in the ENSE11. Results: Of 20,397 people, 1101 (5.4%) visited the physiotherapist the previous year, and the cumulative incidence of total mortality was 5.4% (n = 1107) at a mean follow-up of 6.2 years. Visiting the physiotherapist was associated with lower all-cause mortality in the population residing in Spain, quantified at 30.1% [RR = 0.699; 95% CI (0.528–0.927); p = 0.013]. The factors associated with not visiting a physiotherapist were the following: rating one’s health as good (9.8%; n = 1017; p < 0.001), not having any hospital admission in the previous year (9.6%; n = 1788; p < 0.001), not having visited the general practitioner in the previous month (9.6%; n = 1408; p < 0.001), and not having attended a day hospital in the previous year (9.7%; n = 1836; p < 0.001). Conclusions: Visiting a physiotherapist was associated with a lower mortality from all causes in the population living in Spain.