Nutritional Needs, Dietary Knowledge, and Culinary Skills in Individuals with Diabetes Mellitus: A Scoping Review Jorge Casaña Mohedo, María Teresa Murillo-Llorente, Alma Palau Ferre, María Faus, Barbara Gómez Taylor, Francisca Esteve Claramunt, Sara Morales Palomares, Elena Sandri Advances in Nutrition, 2026 Dietary management is a cornerstone of diabetes mellitus (DM) care. However, a persistent disconnect remains between theoretical nutritional knowledge, what individuals are advised to eat, and the practical culinary skills required to translate these recommendations into daily practice. This gap is frequently compounded by socioeconomic constraints and cultural determinants. To map the available evidence on dietary knowledge, culinary skills, and food-related practices among people with DM, with particular attention to barriers and facilitators in daily-life settings. A scoping review was conducted following the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping reviews guidelines. Major databases (MEDLINE/PubMed, Scopus, Web of Science, and Embase) were searched for studies published between 2014 and 2025. Extracted variables were mapped deductively to the World Health Organization International Classification of Functioning, Disability and Health, distinguishing self-care and dietary management (d5) from domestic-life competencies related to meal preparation (d6). Forty-six studies were included. The evidence base was heterogeneous and focused largely on dietary self-management, whereas comparatively few studies explicitly assessed instrumental cooking skills (n = 8). Across studies, structural barriers, particularly food insecurity and the cost and availability of healthier foods, frequently limited the feasibility of recommended diets. Skills-based interventions, including culinary medicine and hands-on cooking programs, were associated with improvements in culinary self-efficacy and, in some studies, clinically meaningful hemoglobin A1c reductions. Family dynamics, peer support, and culturally shaped practices (including religious observances) emerged as important determinants of adherence. Current diabetes education strategies risk achieving conceptual adequacy without practical applicability. Effective dietary management in DM requires a shift from predominantly prescriptive nutritional advice toward skills-based approaches grounded in culinary medicine. Future interventions should be culturally responsive and explicitly address environmental and social barriers to bridge the gap between clinical recommendations and real-world implementation. This systematic review followed a protocol registered prospectively on Open Science Framework available at: https://doi.org/10.17605/OSF.IO/J9PHQ.
Waist Circumference and Handgrip Strength as Potential Nursing Vital Signs in Type 2 Diabetes: A Preliminary Assessment Barbara Gómez-Taylor, Jorge Casaña Mohedo, Alma María Palau-Ferrè, Rocío Práxedes Gómez, Aáron Quesada Hernández, Ernesto Navarro Escobar, Elena Sandri, Sara Morales Palomares Diabetology, 2026 Background and aims: The aim of this study was to examine the relationships between muscle function, dietary quality, body composition markers, and metabolic status in ambulatory patients with type 2 diabetes. The study sought to validate low-cost tools, such as handgrip strength and waist circumference, as potential “nursing vital signs” for metabolic risk stratification. Methods: A cross-sectional observational study was conducted with adult patients with type 2 diabetes. Muscle function was assessed through handgrip strength (dynamometry) and metabolic status via the HOMA-IR index. Visceral adiposity was estimated using waist circumference and the Lipid Accumulation Product (LAP); dietary quality was evaluated with the Spanish Healthy Eating Index (IASE), and cellular health through the phase angle (PhA) obtained by electrical bioimpedance. Non-parametric tests and Spearman correlations were applied due to the non-normal distribution of the data. Conclusions: In this ambulatory diabetic population, waist circumference emerged as a practical and potent surrogate for insulin resistance burden. Although metabolic dysfunction was not directly associated with dietary quality or phase angle, a high prevalence of probable sarcopenia (36.1%) and poor dietary quality (77.8%) were detected. The implementation of non-invasive tools like waist circumference and handgrip strength in nursing consultations could optimize early risk stratification and allow for more targeted lifestyle interventions.
Study of the Relationship Between Cyberbullying and Mental Health in Adolescents—A Systematic Review Jorge Casaña Mohedo, María Teresa Murillo-Llorente, Marcelino Perez-Bermejo, María Ester Legidos-García, Miriam Martínez-Peris Children, 2026 Background: Cyberbullying has emerged as a major public health concern with profound psychological repercussions on the adolescent population. The shift toward virtual communication has fundamentally altered interpersonal dynamics, removing the spatio-temporal barriers of aggression and creating new challenges for mental health. Methods: A systematic review was conducted following PRISMA 2020 guidelines, including a comprehensive update executed in February 2026. Searches were performed across PubMed, EBSCO, Web of Science, and Scopus. The review included observational and experimental studies involving adolescents (aged 10–19 years) reporting clinical mental health outcomes. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Results: Forty-two high-quality articles were selected. Key findings include the following: Prevalence: A median cyber-victimization prevalence of 19.1% was identified, although significant methodological heterogeneity exists with ranges between 2.1% and 88.0%. Clinical Impact: Victims exhibited significantly elevated rates of depression (90%) and anxiety (87%) compared to uninvolved peers. Suicidality: Victimization is a critical risk factor, with suicide attempts reported in 19.0% of victims, compared to 3.0% in aggressors. Vulnerable Groups: Adolescents with autism spectrum disorder (ASD) demonstrated extreme vulnerability, with victimization rates between 64.1% and 68.9%. Additionally, females and LGBTQ+ youth showed a higher risk of symptom internalization and post-traumatic stress. The Role of the Bystander: Observers experienced fear, moral frustration, and helplessness, acting as either passive reinforcers or active upstanders depending on the school climate. Conclusions and Implications: Effective prevention requires a socio-ecological approach that transcends the classroom, integrating families, healthcare centers, and technological platforms. A transition toward modernized cyber-education is recommended, utilizing interactive tools and “serious games” to foster empathy.
Cross-Sectional Correlational Study in the Valencian Community (Spain) on the Social Image and Attitudes Towards Nursing Silvia Solera-Gómez, David Sancho-Cantus, Jesús Privado, Jorge Casaña Mohedo, Cristina Cunha-Pérez Healthcare Switzerland, 2025 Background: Nursing is an essential pillar in health services provision; however, its social value is often underestimated. The public image of, and society’s attitude toward, the profession is commonly influenced by stereotypes and biases. Objective: This study aimed to analyze the predictive influence of empathy, professional values and communication skills on the social image and attitude towards nursing. Methods: A cross-sectional, correlational study was conducted in the Valencian Community, Spain. Snowball sampling was used for data collection from 300 participants (81% female; mean age 35.85 years, SD = 14.99). Empathy, professional values and communication skills were measured, and a structural equation model was proposed to assess their influence. Results: Professional values were significant predictors of both social image (β = 0.41) and attitude toward nursing (β = 0.34). Similarly, communication skills predicted social image (β = 0.31) and attitude (β = 0.37). Empathy also emerged as a significant, though minor, predictor. Collectively, these three factors explained 30% of the variance in social image and 39% in attitude toward the profession. The main limitations arise from the severe demographic bias of the snowball sample (skewed toward women, young, and highly educated individuals) and the modest explanatory power (R2 of 30–39%). This limits the generalizability of the findings and suggests the need for future research on omitted variables, such as working conditions and organizational culture. Conclusions: Empathy, professional values and communication skills are key competencies contributing to a more positive social image of and attitude toward nursing. Investing in the development of these competencies can significantly enhance the recognition and appreciation of nursing within the healthcare system.
Evaluation of the Effectiveness of Basic Palliative Care Training for Primary Care Nurses in a Health Area in Spain: A Quasi-Experimental Study Isidro García-Salvador, Encarna Chisbert-Alapont, Amparo Antonaya Campos, Clara Hurtado Navarro, Silvia Fernández Peris, Luis Alberto Gómez Royuela, Paz Rodríguez Castellano, Jorge Casaña Mohedo Healthcare Switzerland, 2025 Background/Objectives: The general training in palliative care (PC) offered does not meet the needs of nurses and does not usually impact their clinical practice. The aim of the present study is to analyze the efficacy of a Palliative Care training plan, created and adapted to the specific needs of primary care nurses from the Department of Health Valencia, Doctor Peset. Methods: We executed the designed training plan offered by all the nurses in the department in five sessions lasting a total of 15 h through an active teaching methodology. A quasi-experimental pre-test/post-test study was conducted. The efficiency of the training provided was assessed through a self-administered, validated, anonymous questionnaire (INCUE instrument). Focus groups were conducted with the coordinators of the center to qualitatively assess the results and to propose lines of improvement. Results: The specific training provided to 85 nurses increased the application of PC in all areas of clinical practice (beginning of PC, communication skills, management of symptoms and care plans, legislation, bioethics at the end of life, and coping and loss). After the training, 88.8% passed the practical portion compared to 53.2% who did so previously. The area of lower impact was coping and loss or grief care. The coordinators perceived an improvement in palliative care, indicating the creation of a care protocol as a line of improvement. The percentage of nurses who felt sufficiently or very prepared to work with palliative patients practically doubled (from 23,5% to 42,4%). Conclusions: The directed training, based on the specific needs detected, was efficient and cost-effective. The methodology used had an impact on clinical practice.
Forecasting SARS-CoV-2 outbreak through wastewater analysis: a success in wastewater-based epidemiology Rubén Cañas Cañas, Raimundo Seguí López-Peñalver, Jorge Casaña Mohedo, José Vicente Benavent Cervera, Julio Fernández Garrido, Raúl Juárez Vela, Ana Pellín Carcelén, Óscar García-Algar, Vicente Gea Caballero, Vicente Andreu-Fernández Frontiers of Environmental Science and Engineering, 2025 The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), triggered a global emergency that exposed the urgent need for surveillance approaches to monitor the dynamics of viral transmission. Several epidemiological tools that may help anticipate outbreaks have been developed. Wastewater-based epidemiology is a non-invasive and population-wide methodology for tracking the epidemiological evolution of the virus. However, thorough evaluation and understanding of the limitations, robustness, and intricacies of wastewater-based epidemiology are still pending to effectively use this strategy. The aim of this study was to train highly accurate predictive models using SARS-CoV-2 virus concentrations in wastewater in a region consisting of several municipalities. The chosen region was Catalonia (Spain) given the availability of wastewater SARS-CoV-2 quantification from the Catalan surveillance network and healthcare data (clinical cases) from the regional government. By using various feature engineering and machine learning methods, we developed a model that can accurately predict and successfully generalize across the municipalities that make up Catalonia. Explainable Machine Learning frameworks were also used, which allowed us to understand the factors that influence decision-making. Our findings support wastewater-based epidemiology as a potential surveillance tool to assist public health authorities in anticipating and monitoring outbreaks.
Dietary Beliefs and Their Association with Overweight and Obesity in the Spanish Child Population María Teresa Murillo-Llorente, Alma María Palau-Ferrè, María Ester Legidos-García, Javier Pérez-Murillo, Francisco Tomás-Aguirre, Blanca Lafuente-Sarabia, Adalberto Asins-Cubells, Miriam Martínez-Peris, Ignacio Ventura, Jorge Casaña-Mohedo, Marcelino Pérez-Bermejo Children, 2025 Background/Objectives: Childhood obesity is a multifactorial chronic disease that represents one of the main preventable causes of morbidity and mortality. This study analyzes how nutritional beliefs influence eating habits and the prevalence of overweight and obesity in Spanish children and adolescents. Methods: A cross-sectional study was conducted in 35 educational centers in 12 Spanish provinces, with a sample of 1131 children and adolescents aged 6 to 14 years. Anthropometric and sociodemographic data were collected, and dietary habits were assessed by means of questionnaires. Statistical analyses were used to identify associations between dietary beliefs and body mass index. Results: In total, 29.5% of participants were overweight or obese. Two groups of beliefs were identified: healthier beliefs and less healthy beliefs. Children with less healthy dietary beliefs had a significantly higher BMI (22.16 kg/m2) compared to those with healthier beliefs (17.2 kg/m2). False nutritional beliefs, influenced by advertising and the family environment, contribute to overweight and obesity. Discussion: Dietary beliefs play a crucial role in determining eating habits and, therefore, the health of children. Nutrition education and public policies that promote healthy eating habits are essential to prevent childhood obesity. It is important to involve the family, the school, and the media in these efforts. Conclusions: Despite efforts, many children continue to hold erroneous nutritional beliefs that contribute to the rise in overweight and obesity. This study highlights the importance of addressing dietary beliefs and promoting appropriate nutrition education to prevent childhood obesity. It is recommended to implement educational strategies and public policies that regulate the advertising of unhealthy foods and promote healthy eating habits.
Sacituzumab Govitecan in Triple Negative Breast Cancer: A Systematic Review of Clinical Trials Marcelino Pérez-Bermejo, Mónica Caballero-Pascual, María Ester Legidos-García, Miriam Martínez-Peris, Jorge Casaña-Mohedo, Francisco Llorca-Colomer, Ignacio Ventura, Francisco Tomás-Aguirre, Adalberto Asins-Cubells, María Teresa Murillo-Llorente Cancers, 2024 Background/Objectives: Triple-negative breast cancer is difficult to treat due to the absence of hormone receptors and Her2neu. Sacituzumab govitecan is a new therapeutic approach that uses an antibody directed against the Trop-2 antigen present in solid epithelial tumors, linked to the active metabolite SN-38, similar to irinotecan, to specifically target cancer cells while minimizing damage to healthy cells. The objective of the present review was to evaluate the efficacy and safety of sacituzumab govitecan as a single treatment in patients with triple-negative breast cancer and to compare its results with the standard conventional chemotherapy regimen currently used in this disease. Methods: A systematic review of randomized clinical trials of sacituzumab govitecan was performed. The search was performed in Medline (PubMed), Web of Science, and Cochrane from September 2022 to January 2024. Results: Thirty-eight articles are included and evaluated according to inclusion and exclusion criteria corresponding to the two most relevant clinical trials, including specific analyses of cohorts and subgroup study arms within these trials. Data from more recent clinical trials are also reviewed. Conclusions: The efficacy results showed a significantly greater clinical benefit with sacituzumab govitecan compared to standard chemotherapy in patients with triple-negative breast cancer. This drug will become a treatment of substantial impact in future treatment guidelines for this type of cancer.
Predictive potential of SARS-CoV-2 RNA concentration in wastewater to assess the dynamics of COVID-19 clinical outcomes and infections Raimundo Seguí López-Peñalver, Rubén Cañas-Cañas, Jorge Casaña-Mohedo, José Vicente Benavent-Cervera, Julio Fernández-Garrido, Raúl Juárez-Vela, Ana Pellín-Carcelén, Vicente Gea-Caballero, Vicente Andreu-Fernández Science of the Total Environment, 2023 Coronavirus disease 2019 - caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) -, has triggered a worldwide pandemic resulting in 665 million infections and over 6.5 million deaths as of December 15, 2022. The development of different epidemiological tools have helped predict new outbreaks and assess the behavior of clinical variables in different health contexts. In this study, we aimed to monitor concentrations of SARS-CoV-2 in wastewater as a tool to predict the progression of clinical variables during Waves 3, 5, and 6 of the pandemic in the Spanish city of Xátiva from September 2020 to March 2022. We estimated SARS-CoV-2 RNA concentrations in 195 wastewater samples using the RT-PCR Diagnostic Panel validated by the Center for Disease Control and Prevention. We also compared the trends of several clinical variables (14-day cumulative incidence, positive cases, hospital cases and stays, critical cases and stays, primary care visits, and deaths) for each study wave against wastewater SARS-CoV-2 RNA concentrations using Pearson's product-moment correlations, a two-sided Mann-Whitney U test, and a cross-correlation analysis. We found strong correlations between SARS-CoV-2 concentrations with 14-day cumulative incidence and positive cases over time. Wastewater RNA concentrations showed strong correlations with these variables one and two weeks in advance. There were significant correlations with hospitalizations and critical care during Wave 3 and Wave 6; cross-correlations were stronger for hospitalization stays one week before during Wave 6. No association between vaccination percentages and wastewater viral concentrations was observed. Our findings support wastewater SARS-CoV-2 concentrations as a potential surveillance tool to anticipate infection and epidemiological data such as 14-day cumulative incidence, hospitalizations, and critical care stays. Public health authorities could use this epidemiological tool on a similar population as an aid for health care decision-making during an epidemic outbreak.
