Search Results (1,659)

Introduction: Long COVID-19 is a complex and multifaceted condition characterized by persistent and fluctuating symptoms extending beyond the acute phase of infection. Aim: To explore the health and support experiences of the Spanish population living with long COVID-19. Methodology: A qualitative study with an interpretative phenomenological approach was used. Semi-structured interviews were conducted over 10 months (2023–2024) across 17 Spanish provinces. The sample included 36 participants. Results: Participants reported persistent and fluctuating symptoms that severely limited daily functioning and generated anxiety, depression, and post-traumatic distress. Chronic fatigue and cognitive impairment affected social participation and work performance, frequently leading to absenteeism and job loss. Delayed diagnosis limited professional knowledge, and perceived lack of credibility contributed to dissatisfaction with healthcare services. Family members and patient associations were key sources of emotional and practical support. Conclusions: Long COVID-19 has a multidimensional impact that requires a comprehensive and multidisciplinary approach. Participants’ narratives reveal how underestimation of symptoms, delayed diagnosis, social stigma, limited healthcare and social support, additional family burdens, and disrupted work and social routines create complexity in care and challenge existing health and economic systems. Full article

Background: Over recent decades, Latin America has undergone significant population aging, accompanied by persistent inequalities that adversely affect healthcare access, particularly among Indigenous populations. This scoping review aimed to map and synthesize the available evidence on healthcare access for older Indigenous women in the region, identifying relevant dimensions, barriers, facilitators, and existing knowledge gaps. Methods: A systematic search was performed in scientific databases and gray literature up to 19 June 2026, including studies published between 2020 and 2026 in Spanish, English, or Portuguese. The PCC framework (Population, Concept, Context) was applied. Following a multi-reviewer selection process involving seven reviewers and data extraction using a standardized matrix, the findings were narratively synthesized in accordance with the PRISMA-ScR guidelines. Results: Eleven sources of evidence were included, representing six Latin American countries and including one regional review; qualitative approaches were the most common among the primary studies. Eight dimensions of accessibility were identified: geographic, economic, cultural, organizational, linguistic, functional, administrative, and social. Principal barriers included geographic isolation, poverty, a lack of cultural and linguistic relevance, bureaucratic hurdles, structural racism, and a scarcity of disaggregated data. Facilitators encompassed family and community networks, traditional medicine, local leadership, social programs, and technological/intercultural adaptations such as telemedicine. Compared with the Levesque framework, approachability, appropriateness, and formal system-navigation mechanisms were not clearly represented in the Latin American evidence, while engagement was insufficiently characterized. Conclusions: The findings indicate that structural and cultural barriers continue to persist. Full article

Language barriers hinder healthcare, particularly during case history-taking, a key part of diagnosis. While multilingual artificial intelligence (AI) chatbots offer solutions, there is fragmented evidence of their effectiveness and impact. This systematic review followed PRISMA 2020 guidelines, examining studies published between 2015 and 2025 on multilingual AI chatbots in healthcare across four databases (Google Scholar, Scopus, Web of Science, and PubMed), using a two-stage screening process. Data extraction focused on applications, supported languages, underlying technologies, target populations, and clinical outcomes. From 503 records, 49 studies, covering primary care, telemedicine, oncology, mental health, and other areas, met the criteria. Supported languages included English, Spanish, Arabic, Chinese, Hindi, and other underrepresented languages. In individual system evaluations using heterogeneous methodologies and evaluation settings, AI chatbots achieved a diagnostic accuracy ranging from 72–92%. Core technologies included large language models (LLMs), bidirectional encoder representations from transformers (BERT), a generative pre-trained transformer (GPT), retrieval-augmented generation (RAG), speech recognition, and distillation. The findings show that these improve clinical workflow (30–70% time savings) and patient engagement, reduce language barriers, and promote health equity. However, the overall evidence certainty was low to moderate, reflecting the predominance of prototype and proof-of-concept studies. Multilingual AI chatbots demonstrate a boost in healthcare efficiency, a reduction in language barriers, and the promotion of health equity, but exhibit challenges regarding validation, workflow integration, and evaluation standards, along with ethical issues such as privacy and bias. Future research should include real-world studies, diverse populations, standardized outcome measures, and long-term equity assessments. Full article

Background/Objectives: Highly sensitive persons (HSPs) are characterized by increased emotional and sensory responsiveness, which may predispose them to anxiety, emotional dysregulation, and sensory overload. Music therapy based on gong sound sessions has emerged as a complementary intervention aimed at promoting emotional well-being. This study analyzed immediate pre- and post-intervention variations in an adult population with sensory processing sensitivity. Methods: A quantitative, quasi-experimental, single-group (non-controlled), pre–post intervention study was conducted using music therapy in a sample of N = 93 individuals, who were evaluated during an initial session (62 Highly Sensitive Persons [HSPs] and 31 Non-HSPs), from which a synchronized longitudinal sub-cohort of 39 participants (27 HSPs and 12 Non-HSPs) completed a second exposure. Indicators were assessed using the Questionnaire on the Impact of Music Therapy Sessions in Adult Patients (CISMA), whose technical designation corresponds to an acronym of Spanish-language origin. Results: Participants demonstrated significant score variations following gong sound therapy in each session. In the first session, the mean CISMA score changed by 7.0 points (p < 0.001), while the second session showed a mean variation of 7.0 points (p < 0.001). Participants reported favorable trends in emotional self-regulation, reduced anxiety, mitigated pain intensity, increased tolerance to sensory overload, and greater overall psychological well-being. Conclusions: Music therapy using gong sound appears to be a promising complementary framework, contributing to immediate positive shifts in emotional regulation, anxiety, pain, and sensory distress. Within the limitations of this non-controlled framework, these immediate shifts describe a specific statistical variation within the observed sample, which cannot be generalized as clinical efficacy. Controlled trials are needed to confirm these insights and show the potential integration of music therapy using gong sound into holistic nursing and mental health care models. Full article

Background: Evidence on the real-world effectiveness of antiresorptive therapy for hip fracture prevention in very old women remains limited. We aimed to assess the association between antiresorptive use and incident hip fracture among age ≥ 75 older women with osteoporosis. Methods: We conducted a population-based nested case–control study using the Base de Datos para la Investigación Farmacoepidemiológica en Ámbito Público (BIFAP), a Spanish research database. Women aged 75 years or older with osteoporosis and no previous antiresorptive use at cohort entry were followed from 2010 to 2022. Incident hip fracture cases were matched to risk-set controls by age, autonomous region, and calendar year of database registration. Antiresorptive exposure was classified as current, recent, past, or never use. Conditional logistic regression was used to estimate adjusted odds ratios (aORs) and confidence intervals. Results: The study included 2057 incident hip fracture cases and 19,275 matched controls. Compared with never users, current antiresorptive users had lower odds of hip fracture (aOR 0.76; 0.65–0.87), whereas past users had higher odds (aOR 1.91; 1.57–2.33). Ever use was not associated with hip fracture risk compared with never use (aOR 1.01; 0.90–1.13). Conclusions: In this real-world nested case–control study of women aged ≥75 years with osteoporosis, current antiresorptive use was associated with lower odds of hip fracture, whereas past use was associated with higher odds. Because treatment initiation, persistence, and discontinuation are strongly influenced by baseline fracture risk, osteoporosis severity, frailty, and clinical surveillance, these findings should be interpreted as associations rather than causal treatment effects. Full article

Conspiracy beliefs targeting lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals have attracted increasing attention in social and political psychology due to their role in prejudice, social exclusion, and resistance to social change. Despite growing interest in this phenomenon, validated instruments for assessing LGBTQ+-related conspiracy beliefs in Spanish-speaking populations remain limited. The present study aimed to adapt and evaluate the psychometric properties of the Spanish version of the Gender Ideology and LGBTQ+ Lobby Conspiracies Scale (GILC) in a Chilean sample. A total of 611 participants completed the instrument. Evidence based on internal structure was examined using parallel analysis, psychometric network analysis, confirmatory factor analysis (CFA), and measurement invariance testing across sex assigned at birth. Evidence based on relations with external variables was assessed through sociodemographic characteristics, religiosity, political orientation, and generic conspiracy beliefs. Results consistently supported a predominantly unidimensional structure. The CFA showed that the original one-factor model achieved satisfactory fit after incorporating two theoretically meaningful residual correlations. In addition, the scale demonstrated configural, metric, and scalar invariance across sex assigned at birth. GILC scores were positively associated with generic conspiracy beliefs, religiosity, age, and right-wing political orientation. Overall, the findings provide support for the validity of the Spanish version of the GILC and suggest that it constitutes a useful tool for studying LGBTQ+-related conspiracy beliefs in Spanish-speaking contexts. Full article

Background/Objectives: End-of-life (EOL) preparedness remains critically understudied among Hispanic patients with advanced breast cancer and their patient–caregiver dyads, despite evidence that preparedness significantly influences quality of life, care decisions, and caregiver well-being. This study aimed to explore how Hispanic patient–caregiver dyads conceptualize and experience EOL preparedness. Methods: A qualitative descriptive design was employed, guided by the Dyadic Cancer Outcomes Framework, which highlights patient and caregiver characteristics, relationship processes, individual and relational outcomes, the cancer care trajectory, and the broader social context as interrelated influences on dyadic experience. Semi-structured individual interviews were conducted in Spanish with 11 metastatic patient–caregiver dyads (n = 22 participants) recruited through Ponce Health Sciences University and the Ponce Research Institute in Puerto Rico. Data were analyzed using codebook thematic analysis in NVivo 15, with themes interpreted through the framework’s components. Results: Six interdependent themes of EOL preparedness were identified: psychological and emotional, spiritual, informational, practical, physical, and caregiver role preparedness. Spiritual preparedness, grounded in faith, prayer, and surrender to divine will, functioned as the foundational axis organizing all other themes. Preparedness was dynamic and turning-point-driven, challenged anew at each stage of disease progression. Financial vulnerability, caregiver invisibility within formal care systems, and insufficient anticipatory information were identified as primary barriers. Family support and faith communities were the most consistently cited facilitators. Conclusions: The findings yield the first grounded, dyadic conceptualization of EOL preparedness with Hispanic advanced breast cancer patient–caregiver dyads. We propose a formal definition positioning preparedness as a dynamic, multidimensional, relationally embedded, and spiritually anchored process that is fundamentally interdependent between patient and caregiver. These results directly inform the development of a culturally tailored, dyadic EOL preparedness intervention for this underserved population. Full article

This study examines the use of function words in adult individuals with Williams syndrome (WS) compared to typically developing (TD) speakers, focusing on spontaneous speech in Catalan and Spanish. The aim is to assess both quantitative and qualitative aspects of function word production and to explore whether WS is associated with distinct grammatical processing patterns. The corpus consisted of 20 five-minute transcripts, equally divided by language (Catalan/Spanish) and group (WS/TD). Analyses included counts of function word categories, error types, and mean length of utterance in morphemes (MLUm). Statistical procedures (t-tests, ANOVA, Mann–Whitney tests, and MANOVA with bootstrapping) were applied depending on distributional assumptions. Results showed significant differences between WS and TD groups in several categories, including prepositions, conjunctions, definite articles, numerals, adverbs, and relative pronouns, with large effect sizes in some cases. MLUm was also significantly lower in the WS group. In contrast, no significant effects of language or interaction between language and group were found. These findings indicate that WS has a robust impact on grammatical usage, particularly affecting function words, independently of language. On the whole, the results support the view that WS is associated with atypical linguistic profiles and contribute cross-linguistic evidence from Romance languages, highlighting the need for further research on language processing in this population. Full article

Background/Objectives: Achieving guideline-recommended low-density lipoprotein cholesterol (LDL-C) targets in patients with chronic coronary syndrome (CCS) remains challenging despite intensive lipid-lowering therapy. Bempedoic acid (BA) offers an oral therapeutic option, although data on its clinical performance and patient-level determinants of response in real-world Spanish settings are limited. Methods: We conducted a prospective multicentre study across the four healthcare areas of Cáceres province, Spain, including consecutive CCS patients with LDL-C ≥ 55 mg/dL despite stable intensive lipid-lowering therapy. BA 180 mg/day was added to background treatment. Lipid parameters, metabolic profile, and safety outcomes were assessed after a median follow-up of 28 weeks (IQR 23–47). Multivariable analyses were performed to identify factors associated with of LDL-C reduction and target attainment. A total of 118 patients were analyzed for outcomes. Results: A total of 118 patients (mean age 62.4 ± 10.0 years; 79.2% male) were included. BA reduced LDL-C by 22.8% (−16.36 mg/dL; p < 0.001), enabling 48.3% of patients to achieve LDL-C < 55 mg/dL. Higher baseline LDL-C (β = −0.515; p = 0.001) and the presence of diabetes mellitus (B = 13.8 mg/dL; p = 0.024) were independently associated with greater LDL-C reduction. Notably, 56.3% of patients presented with elevated baseline lipoprotein(a) levels (>50 mg/dL), describing a high underlying burden of residual risk. BA was well tolerated, with a modest increase in uric acid levels but no gout events and a high treatment persistence rate (94.4%). Conclusions: In a real-world CCS population receiving intensive lipid-lowering therapy, BA provides clinically meaningful LDL-C reduction with a favorable safety profile in this multicentre cohort from Cáceres province. Patients with higher baseline LDL-C and diabetes derive greater benefit, supporting a more personalized approach to therapy. These findings reinforce the role of BA in Spanish patients as an intermediate step in lipid-lowering strategies before escalation to more costly therapies, addressing the scarcity of local real-world data. Full article

Most instruments used to assess depression have been developed in sociocultural contexts that differ substantially from those of Spanish-speaking Latin American populations. To address this limitation, the present study developed and evaluated a new brief measure of depressive symptomatology for use in northeastern Mexico. The study included 414 participants (Mage = 27.37 years, SD = 13.72). An initial pool of 23 items, grounded in interbehavioral psychology, was developed and subsequently evaluated by a panel of 58 expert judges. Based on content-validity analyses, the instrument was reduced to 15 items. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) supported a final four-item, one-factor solution. The final model demonstrated adequate fit to the data (χ²/df = 0.281, AGFI = 0.993, NNFI = 1.015, CFI = 1.000, RMSEA = 0.000, 90% CI [0.000, 0.094], and SRMR = 0.008). Evidence of discriminant and convergent validity was supported by a negative correlation with the Subjective Happiness Scale (r = −0.294, p < 0.01) and a positive correlation with the seven-item version of the Center for Epidemiologic Studies Depression Scale (CESD-7; r = 0.273, p < 0.01). Construct reliability was satisfactory (H = 0.841). Overall, the findings provide preliminary evidence supporting the reliability and validity of the proposed instrument as a brief screening measure of depressive symptomatology in a Mexican sample, mostly from Nuevo León. Full article

This study comparatively analyzes the effectiveness of social reintegration in the Spanish civilian and military prison systems, using re-imprisonment recidivism as an inverse proxy indicator. Official administrative data for the 2009–2019 period were analyzed for the civilian system (n = 19,909) and the military system (n = 644), the latter comprising 539 released individuals with complete outcome data and 105 transferred to the civilian system whose post-release outcomes were unavailable. To address this missing information, a sensitivity analysis was implemented under three transparent, a priori scenarios (conservative, intermediate, and optimal). The civilian reintegration rate was 80.02%, whereas the military rate ranged from 95.19% to 98.14% across scenarios. The military advantage was substantial and consistent (absolute risk difference +15.17 to +18.13 percentage points; all p < 0.001; large effect sizes). However, the two populations differ markedly in prior criminal history, offense type, and risk/protective factor profiles; the observed gap therefore reflects the combined effect of population selection and institutional factors and should be interpreted as descriptive rather than causal. These findings establish a robust empirical phenomenon and generate testable hypotheses for future comparative and quasi-experimental research on penitentiary effectiveness. Full article

Background/Objectives: Children with special healthcare needs (CSHCN) face significant barriers to conventional dental care and frequently require general anaesthesia (GA). Data characterising the clinical and therapeutic profile of this population in the Spanish public health system remain scarce. This study aimed to describe the systemic conditions, oral pathology, and dental procedures performed in CSHCN attending a tertiary-care paediatric oral and maxillofacial surgery service, and to characterise the subgroup of patients requiring treatment under GA relative to the wider clinic population. Methods: A retrospective, descriptive, observational study was conducted at the Hospital Universitario y Politécnico La Fe (Valencia, Spain) from November 2022 to February 2026. Data were extracted from electronic health records for 160 outpatient clinic patients aged 0–14 years (70.6% male), of whom 42—a subgroup, not an independent sample—subsequently underwent dental treatment under GA (76.2% male). Sex, age, and autism spectrum disorder (ASD) status were compared between the GA subgroup and a non-overlapping outpatient-only comparator (n = 118) using Fisher’s exact test and Welch’s t-test. Results: ASD was the most prevalent systemic condition in both the outpatient clinic (25.0%) and the GA subgroup (42.9%); a statistically significant association with ASD status was observed against the non-overlapping outpatient-only comparator (18.6% ASD; p = 0.003), while sex (p = 0.432) and age (p = 1.00) did not differ. Dental caries was the most common finding at outpatient assessment (61.0%), followed by root remnants (32.1%). Among GA patients, tooth extraction was performed in 78.6%, composite restoration in 71.4%, and professional dental cleaning in 50.0%. The mean number of procedure types per GA patient was 2.5 ± 1.0 (range 1–5); 81.0% received two or more procedure types in a single session. Conclusions: CSHCN attending this service present advanced oral disease, and those referred for GA had a significantly higher prevalence of ASD than the remaining clinic population, requiring complex, multi-procedure interventions in a single session. The wide geographic pattern of referrals suggests that further evaluation of the distribution of hospital dental services within the public health network may be warranted, and caregiver-targeted preventive programmes may represent a promising strategy to reduce the oral disease burden in this population. Full article

An important role of neuroinflammation in the pathogenesis of Parkinson’s disease (PD) has been proposed. Since some microRNAs (miRNAs), and miR-155 in particular, are involved in neuroinflammatory processes, a previous study reported an association between one of the most common single nucleotide variants (SNVs), rs767649, in the MIR155 gene, and risk for PD. The aim of the current study was to replicate this finding in a larger Spanish population case–control series. We analyzed genotype and allele frequencies of the MIR155 rs767649 SNV in a Spanish Caucasian cohort consisting of 459 PD patients and 460 age- and sex-matched healthy controls, using a TaqMan allelic discrimination assay specifically designed for rs767649. The genotype frequencies of the MIR155 rs767649, under codominant, dominant, recessive, and overdominant inheritance models, as well as allelic frequencies, showed no significant differences between PD patients and healthy controls. Likewise, the age at PD onset did not differ among the three MIR-155 rs767649 genotypes. These data did not identify a statistically significant association between MIR155 rs767649 variants and PD risk. However, the low frequency of the variant allele resulted in limited statistical power, and modest genetic effects cannot be excluded. Full article

Background/Objectives: Bipolar disorder (BD) is a chronic psychiatric condition associated with substantial emotional and psychosocial burden. Social media platforms provide an opportunity to examine how BD is discussed and emotionally framed outside clinical settings. Although Spanish-language public discourse on BD remains underexplored, this gap is particularly relevant given that linguistic and cultural factors may influence how mental health conditions are expressed, perceived, and communicated. Understanding these differences is essential for developing culturally sensitive public health strategies, improving mental health literacy, and addressing stigma in diverse populations. Methods: A retrospective observational study was conducted using Spanish-language tweets referring to BD posted between 2007 and 2023. After preprocessing, 170,411 unique tweets were analyzed. Latent Dirichlet Allocation (LDA) was applied to identify dominant thematic domains, and emotional tone was classified using a RoBERTa-based model adapted from Ekman’s basic emotions. Statistical analyses were performed to examine associations between topics, emotional categories, and the presence of clinical terminology. Results: Tweet activity related to BD remained low until 2019, followed by a marked increase peaking in 2020 and remaining elevated thereafter. Topic modeling identified seven main themes, predominantly centered on symptoms, illness-related life crises, social anxiety, help-seeking, and the impact of BD on romantic relationships, while diagnosis- and treatment-related topics were less frequent. Emotional analysis showed a clear predominance of sadness across all topics, accounting for approximately 75% of tweets. Anger, joy, and optimism were present at lower frequencies and varied across thematic domains. Clinical terminology was significantly more common in diagnosis- and treatment-related topics, whereas experiential and affective narratives dominated the remaining themes. Conclusions: Spanish-language discourse on BD on Twitter is largely characterized by emotional expression and lived experience rather than biomedical language. These findings highlight cultural relevance of social media as a complementary source for understanding public perceptions of BD and underscore the importance of culturally and linguistically specific analyses in digital mental health research. Full article

Background: Although cervical cancer is preventable, Latinas are twice as likely to receive a late diagnosis compared with non-Hispanic Whites (NHW). We currently know very little about the experiences of cervical cancer among middle- to older-age Latinas in the U.S. This study aimed to document Latina cervical cancer survivors’ journeys with an emphasis on improving the cervical cancer system of care to address inequities among a rapidly aging Latina population. Methods: We interviewed participants aged ≥ 40 years with a diagnosis of cervical cancer of three months or greater who identify as Latina. Recruitment was multi-pronged, including electronic healthcare records search, community tabling events, and snowball sampling. We conducted a qualitative study using the Database of Individual Patient Experiences (DIPEx) methodology and identified themes using grounded theory constructivist analysis. Results: A total of 20 Latinas (43 to 85 years old) participated, including 16 Spanish-language interviews. We identified three themes: formative experiences driving screening and prevention behaviors, provider communication that was suboptimal throughout the cancer continuum, and survivorship impacts including isolation and stigma with implications for the next generation. Conclusions: A central takeaway was the pervasiveness of Latinas’ feelings of shame, lack of communication, and isolation. Healthcare systems must improve culturally responsive communication, survivorship support, and screening equity for aging Latina populations. Abuelas, tias, and/or primas (grandmothers, aunts, and cousins) could play a critical role in raising awareness and increasing timely and early screening among the wider Latina population. Full article