Parc Sanitari Sant Joan de Déu

Background Despite growing scientific evidence and health guidelines, the global health paradox persists, with rising lifestyle-related diseases and escalating healthcare costs exposing the inadequacy of current efforts. Objective Three multidisciplinary congresses were held to generate evidence-based conclusions aimed at addressing the global health paradox. Methods A total of 58 experts from 62 entities participated in the international research and knowledge-exchange panels. Experts reviewed the latest findings to develop practical strategies and identify key research and policy priorities, focusing on the Healthy Eating & Active Living (HEAL) approach. Results, conclusion, and relevance The expert consortium endorsed a 33 evidence-based consensual-statement policy roadmap for addressing global health challenges, emphasizing that the HEAL approach can significantly contribute to the “Prevention First” appeal and broad ethical, social, ecological, and economic advantages, and ultimately supporting policy change.

Psilocybin-assisted therapies are innovative therapeutic approaches, particularly in the treatment of depression. However, there are sparse studies providing functional magnetic resonance imaging (fMRI) evidence elucidating the underlying biological mechanisms that support clinical outcomes. This review aims to comprehensively gather all the evidence reported in psilocybin studies using fMRI techniques. Independent extraction of articles was conducted by 2 authors using predefined data fields. 20 unique datasets were identified, with 5 including participants diagnosed with depression. Dropout rates were found to be high, and follow-up scanning timepoints were lacking in most of the studies. Most research has focused on the amygdala, the anterior cingulate cortex and the prefrontal cortex, as key regions involved in the effects of psilocybin. However, the current literature exhibits inconsistency in methods and designs. Further research is necessary to better define psilocybin’s impact on the human brain and its potential to enhance psychotherapy outcomes.

Although metacognitive training (MCT) and cognitive-behavioural therapy (CBT) have been proven to be effective interventions for the treatment of symptoms of schizophrenia, still little is known about the effects on quality of life (QoL). This systematic review compares the effectiveness of MCT and CBT-based interventions for QoL in individuals with schizophrenia spectrum disorders (SSD). Three electronic databases were screened up to October 2025 for MCT and CBT studies reporting QoL outcomes for patients diagnosed with SSD. Data from 38 randomized controlled trials (RCTs) met the inclusion criteria, of which eight MCT and 30 studies included CBT-based interventions. When comparing MCT against control interventions, none of the eight MCT studies found significant differences in the overall score of QoL scales at posttest and at 1- or 6-month follow-up. Only one study has assessed the effects of MCT after 3 years, yet it demonstrated significant improvements in QoL. For CBT-based interventions, nine of 26 available between-group comparisons in overall QoL showed a significant improvement in QoL after CBT at the posttest, and five of 19 effects were observed at follow-up. This review provides modest evidence for improvements in QoL from CBT-based interventions and a small number of studies concerning QoL in MCT, emphasizing the need for further research that prioritizes QoL as a primary outcome as well as the need for research with longer follow-ups to capture the delayed effects of MCT and CBT on QoL. It awaits to be tested whether the recent extension of MCT (app, 2 modules on self-esteem and stigma) augments QoL.

ABSTRACTBackgroundCommunity pharmacy workers (CPW) have a crucial role in enhancing patients' understanding and empowerment about their disease in accordance with their health literacy (HL) level. We aimed to explore the barriers and enablers of CPWs' behaviours regarding HL in the interactions with patients with chronic conditions: 1/assessing patients' HL level and 2/tailoring communication to HL level.MethodsWe conducted a cross‐sectional sequential explanatory mixed‐method study. The study was underpinned by the theoretical domain framework (TDF) that maps the key psychological and organizational factors that influence behavior of health professionals. First, an online self‐completed questionnaire on TDF determinants of implementation behavior was sent to CPWs (pharmacists and pharmacy technicians in Auvergne‐Rhône‐Alpes, France). Findings were analysed using the confidence interval‐based estimation of relevance method. Second, semi‐structured interviews were conducted with a sample of survey respondents, to detail the information previously gathered.ResultsAmong the 111 respondents (91 pharmacists and 20 technicians), 84% stated that they were not aware of the concept of HL. However, after being shortly introduced to HL, most claimed to informally assess patient HL level and adapt their communication accordingly, however their assessment was described as based on subjective and unstructured approaches. Key barriers were the lack of an adapted environment (no clear indication in the pharmacy environment), resources (lack of time, staff, specific remuneration, tools dedicated to assess patients' HL level), and habitual behavior (they did not routinely assess all patients' HL and the time of the day influenced whether they adapt or not their communication to patients' HL level), and the difficulties to contact other healthcare providers (to have a multidisciplinary approach to improve patients' HL level).ConclusionsThis study identified determinants that could be targeted to enhance adoption of HL‐tailored communication techniques in community pharmacy. Our results might guide the development of effective theory‐based interventions to improve communication practices among CPW.

BackgroundWhile psychological interventions are effective at improving symptoms of psychosis, accessible, cost- and time-efficient treatments remain limited. Personalized medicine has emerged as a promising approach, tailoring interventions to individual needs. Metacognitive Training (MCT), with its established efficacy and adaptable format, is well-suited for personalization. The PERMEPSY project (Towards a Personalized Medicine Approach to Psychological Treatment for Psychosis) aims to deliver tailored MCT intervention for individuals with psychosis.MethodsPERMEPSY is an international study funded by ERAPerMed (JTC2022) involving five clinical partners (Spain, Chile, France, Germany, Poland) and one technological partner (Spain). The project involves a proof-of-concept clinical trial recruiting 51 participants from each center for a total of 255 adult participants with psychosis in a prospective study (Registration: NCT06603922, 19-09-2024). The trial will test the efficacy of a Machine Learning (ML)-derived platform at predicting clinical and functional outcomes from baseline scores and compare a personalized MCT (P-MCT) to a classical MCT based on the platform’s predictions.AimsPERMEPSY seeks to (1) develop and test the predictive power of an algorithm that could support decision-making, and (2) ascertain whether P-MCT is more effective than MCT at improving key symptoms and cognitive impairments associated to psychosis.ResultsA harmonized retrospective database enabled the development of a predictive ML algorithm, integrated into an innovative platform. This platform provides clinicians with the information needed to deliver P-MCT. Predictions include changes in positive symptoms (e.g., delusions), insight, self-esteem, and treatment adherence.DiscussionBy integrating diverse data types and innovative technology, PERMEPSY addresses the need for personalized, effective treatment in psychosis, aiming to reduce individual and systemic burdens while supporting clinicians in their decision-making.

Asthma affects over 339 million people worldwide, contributing substantially to morbidity, reduced quality of life, and premature mortality. Air pollution is a major risk factor, but stationary monitors lack the resolution to capture individual exposure. This study aimed to (i) evaluate the feasibility of integrating personalized air quality monitoring with digital health tools in patients with moderate-to-severe asthma; (ii) explore preliminary associations between pollutant exposures and respiratory outcomes; and (iii) characterize interrelations among symptoms, spirometry, wearable-derived physiology, and inhaler use. Thirteen adults with moderate-to-severe asthma participated in a six-month observational study using a digital monitoring ecosystem. This combined wearable sensors for physiological and air quality data, daily symptom reporting via smartphone, and spirometry assessments. Outdoor pollution data were obtained from the nearest fixed-site monitoring station. Personal sensors revealed highly variable exposures that diverged from ambient measurements, particularly for nitrogen dioxide, which showed greater variability and more frequent exceedances of World Health Organization thresholds. Self-reported symptoms and inhaler use were strongly correlated. However, no consistent associations were observed between pollution exposure and health outcomes, including symptoms or spirometry results, even when time-lagged effects were considered. These findings highlight the limitations of relying on ambient stations to assess exposure in asthma research and underscore the importance of individualized monitoring. Combining wearable pollution sensors with continuous symptom tracking and remote lung function testing is feasible and patient-centered. This integrative approach may inform precision medicine strategies and improve individualized asthma management.

Background and Objectives:A medically serious suicide attempt (MSSA) has been defined as a suicide attempt that would be fatal if not for medical intervention. Despite the seriousness of MSSA, the risk factors are only partially understood. The main aims of the present study were to define the characteristics of patients admitted to a general hospital for MSSA and to identify the predictors of MSSA.Methods:Prospective, observational case-control study involving adult inpatients admitted to non-psychiatric units at our institution and consecutively referred to the consultation-liaison psychiatry (CLP) unit between January 1, 2011 and December 31, 2018. Cases were patients who met clinical criteria for MSSA and controls were patients referred to the CLP unit for any other reason. All participants underwent a structured psychiatric interview. Sociodemographic, clinical, and psychosocial data were collected. Univariate and multivariate analyses were performed. Variables that were statistically significant on the univariate analysis were entered into a multivariate binomial logistic regression model.Results:A total of 5428 patients were included: 223 (4.1%) cases and 5205 (95.9%) controls. On the multivariate analysis, the variables significantly associated with the risk of MSSA were: younger age (odds ratio [OR] = 0.98); history of previous suicide attempts (OR = 17.41): psychosocial stressors (interpersonal problems, OR = 2.33; legal problems, OR = 3.38; multiple stressors, OR = 2.28); and presence of severe mental illness (schizophrenia, OR = 6.32; mood disorder, OR = 6.77; personality disorder, OR = 6.35).Conclusions:The findings of this study highlight the importance of early identification of individuals who present with risk factors for MSSA to enable timely intervention. The prompt intervention of CLP services plays a key role in improving patient outcomes, underscoring the importance of specialized, comprehensive psychiatric care in this patient population.

Background:Patients with epithelial ovarian cancer (EOC) receiving neoadjuvant platinum-based chemotherapy (NACT) who remain ineligible for complete interval cytoreductive surgery (ICS) due to poor chemosensitivity (CA-125 KELIM™ score <1.0) have a poor prognosis (~20% 5-year survival). A weekly dose-dense carboplatin–paclitaxel regimen may improve outcomes in this high-risk subgroup.Objectives:To demonstrate the superiority of a salvage weekly dose-dense carboplatin–paclitaxel regimen over continuation of the standard 3-weekly regimen in poor-prognosis EOC patients after 3–4 cycles of standard NACT.Design:SALVOVAR is a pragmatic, open-label, multicenter, international, randomized phase III trial.Methods and analysis:Patients with stages III–IV high-grade EOC are eligible if they present (1) an unfavorable standardized KELIM score <1.0, and (2) a disease not amenable to complete ICS after 3–4 cycles of standard 3-weekly carboplatin–paclitaxel. Patients are randomized (1:1) to either the experimental arm (dose-dense carboplatin AUC5 day 1 plus paclitaxel 80 mg/m2 on days 1, 8, and 15, every 3 weeks) or the control arm (continuation of the standard regimen) for 3 cycles. Bevacizumab use is allowed at investigator discretion. Stratification factors include planned bevacizumab administration, BRCA mutation status, and KELIM strata. The two co-primary endpoints are (1) improvement in late complete cytoreduction rates (from 5% in the control arm to 20% in the experimental arm), and (2) overall survival (target hazard-ratio, 0.61). Total 250 patients will be randomized. Secondary endpoints include objective response rate, progression-free survival, and safety. Additional planned analyses include quality-of-life, cost-effectiveness, surgical standardization, human sciences, and biology studies.Ethics:The protocol was approved by the national ethics committee and health authorities.Discussion:SALVOVAR will evaluate whether chemotherapy densification improves outcomes in poorly chemosensitive advanced EOC. If positive, this pragmatic strategy could be implemented in large-scale studies, independent of resource setting.Trial registration:ClinicalTrials.gov NCT06476184 (June-2024). Available at: https://clinicaltrials.gov/study/NCT06476184