Information For Healthcare Professionals Research Articles

The role of the pharmacist during the first year of the COVID-19 pandemic: an updated scoping review

Abstract Objective To identify new articles that describe services provided by pharmacists during the first year of the COVID-19 pandemic. Methods An update scoping review was conducted in MEDLINE, Embase, Scopus, LILACS, and Google Scholar between 21 May 2020 and 31 May 2021. Study selection and data extraction were performed by two independent authors. DEPICT v. 2 was used to characterize the components of pharmacists’ interventions. It was also verified whether the articles evaluated outcomes of care. Key findings A total of 8983 records were identified, of which 120 met the inclusion criteria. The hospital was the workplace of the pharmacist most often described (55%). The majority of articles (73.3%) described the main domains of DEPICT v.2. Pharmacists provided interventions for patients (27.5%), healthcare professionals (25.8%), both (34.2%), individually (84.2%), through face-to-face contact (44.2%), and followed by telephone (41.7%). The main actions included patient counseling (56.7%), drug supply management (42.5%), and drug information for healthcare professionals (40.8%). Less than half of the articles (36.6%) evaluated the dimension “outcomes of care” of the study population. Conclusion Although most of the articles reported the pharmacists’ interventions, the description is still not satisfactory. In addition, the majority of articles focused solely on the dimension “process of care”. Future research should provide more detailed descriptions of the pharmacists’ interventions and assess the effectiveness of their interventions.

Caregiver burden after stroke: a 10-year follow-up study of Polish caregivers for stroke patients

BackgroundA long-term assessment of stroke outcomes from the perspectives of patients and their caregivers is important for optimising long-term post-stroke care. The extended effects of stroke caregiving, particularly caregiver burden beyond 5 years since stroke, remain to be determined. Hence, this study aimed to determine caregiver burden at 10 years after stroke, compare the burden severity at 10 years with its levels at 5 years and 6 months after stroke, and identify predictors of the burden severity at 10 years post-stroke.MethodsA longitudinal follow-up study including a group of first-ever stroke patients/informal continuous caregivers pairs was followed for 10 years and interviewed face-to face at their home setting.Caregiver burden was evaluated with the Caregiver Burden Scale. Potential predictors were examined using standardised measures and identified by applying the Classification and Regression Tree.ResultsA total of 40 caregiver/patient pairs participated in the study. At 10 years, 47.5% of the caregivers experienced a considerable burden. This was more than after 5 years (17.5%) and comparable to that after 6 months (37.5%), p < 0.003. Longer time spent caregiving, caregivers’ weaker sense of coherence, more severe stroke, and caregivers’ anxiety were the independent predictors of considerable burden 10 years after stroke.ConclusionsCaregivers’ burden in the late chronic post-stroke phase is a significant problem, as nearly half of the caregivers experience a substantial burden. This problem mainly concerns individuals who spend at least 7 h daily caregiving and have a lower Sense of Coherence.The long-term evaluation of stroke consequences reported by stroke patients and their caregivers can be an important source of information for healthcare professionals in order to optimise the care and support they provide at various stages of life after stroke.

New Insights Concerning Phytophotodermatitis Induced by Phototoxic Plants.

The present review explores the underlying mechanisms of phytophotodermatitis, a non-immunologic skin reaction triggered by certain plants followed by exposure to ultraviolet radiation emitted by sunlight. Recent research has advanced our understanding of the pathophysiology of phytophotodermatitis, highlighting the interaction between plant-derived photosensitizing compounds (e.g., furanocoumarins and psoralens) and ultraviolet light leading to skin damage (e.g., erythema, fluid blisters, edema, and hyperpigmentation), identifying these compounds as key contributors to the phototoxic reactions causing phytophotodermatitis. Progress in understanding the molecular pathways involved in the skin's response to these compounds has opened avenues for identifying potential therapeutic targets suitable for the management and prevention of this condition. The review emphasizes the importance of identifying the most common phototoxic plant families (e.g., Apiaceae, Rutaceae, and Moraceae) and plant species (e.g., Heracleum mantegazzianum, Ruta graveolens, Ficus carica, and Pastinaca sativa), as well as the specific phytochemical compounds responsible for inducing phytophototoxicity (e.g., limes containing furocoumarin have been linked to lime-induced photodermatitis), underscoring the significance of recognizing the dangerous plant sources. Moreover, the most used approaches and tests for accurate diagnosis such as patch testing, Wood's lamp examination, or skin biopsy are presented. Additionally, preventive measures such as adequate clothing (e.g., long-sleeved garments and gloves) and treatment strategies based on the current knowledge of phytophotodermatitis including topical and systemic therapies are discussed. Overall, the review consolidates recent findings in the field, covering a diverse array of phototoxic compounds in plants, the mechanisms by which they trigger skin reactions, and the implications for clinical management. By synthesizing these insights, we provide a comprehensive understanding of phytophotodermatitis, providing valuable information for both healthcare professionals and researchers working to address this condition.

Patients' Identification, Management and Prevention of Adverse Drug Reactions: A Cross-Sectional Survey of Patients with Severe Adverse Drug Reactions.

Background: Few studies have been conducted on how patients identify, manage, and prevent severe adverse drug reactions (ADRs). This study aimed to explore the reasoning that patients use to identify symptoms of severe ADRs and the methods they employ to manage and prevent them. Methods: A cross-sectional survey using structured telephone interviews was administered to patients with a self-assessed severe ADR and to patients with serious skin ADRs from a hospital medical record database (in-patient and out-patient) from 1 September 2016 to 1 September 2019. Patients identified via the medical records were asked to assess their ADR for severity, and only patients that rated their ADR as severe were followed up with a telephone interview. Structured telephone interviews were conducted with respondents by a research pharmacist and audio-recorded. Results: A total of 722 patients with a severe ADR were identified, with 300 completing the interview (41.6%). The most frequently cited reasons for classifying ADRs as severe was worsening ADR symptoms (58.3%), severe ADR symptoms (44.4%), and ADR symptoms interfering with their life (36.4%). Only severe ADR symptoms were significantly different between the questionnaire and the medical records database groups (p = 0.007). The most frequent method of ADR management was discontinuation of drug by physicians (88.3%). About 79.0% of patients stated that they increased their carefulness when using other drugs after experiencing ADRs. The main method patients used to prevent ADRs was informing healthcare professionals (HCPs) about their drug allergy history (65.7%). Conclusions: Worsening ADR symptoms were often used to identify severe ADRs. However, HCPs were mainly responsible for the management and prevention of severe ADRs. Increasing awareness of ADRs by HCPs, and providing additional drug information, may improve patient safety.

What makes advance care planning discussion so difficult? A systematic review of the factors of advance care planning in healthcare settings.

Existing systematic reviews related to advance care planning (ACP) largely focus on specific groups and intervention efficacy or are limited to contextual factors. This research aims to identify the modifiable factors perceived by different users of ACP in healthcare settings and inform healthcare professionals about the factors affecting ACP practice. Five English-language databases (ProQuest, PubMed, CINAHL Plus, Scopus, and Medline) and two Chinese-language databases (CNKI and NCL) were searched up to November 2022. Empirical research identifying factors related to ACP in healthcare settings was included. ACP is defined as a discussion process on future end-of-life care. Thematic synthesis was performed on all included studies. A total of 1871 unique articles were screened; the full texts of 193 were assessed by 4 reviewers, and 45 articles were included for analysis. Twenty-two (54%) studies were qualitative, 15 (33%) were quantitative, and 6 (13%) used mixed methods. Foci varied from 28 (62%) studies on a single subject group (either patient, family, or physician), 11 (25%) on 2 subject groups (either patient and family or patient and healthcare professional), and 6 (13%) covered 3 subject groups (patient, family, and healthcare professional). Among the 17 studies involving more than 1 subject group, only 2 adopted a dyadic lens in analysis. Complex interwoven factors were categorized into (1) intrapersonal factors, (2) interpersonal factors, and (3) socio-environmental factors, with a total of 11 themes: personal belief, emotions, the burden on others, timing, responsiveness, relationship, family dynamics, experience, person taking the lead, culture, and support. Patients, families, and healthcare professionals are the essential stakeholders of ACP in healthcare settings. Factors are interweaved among the intrapersonal, interpersonal, and socio-environmental dimensions. Research is warranted to examine the dynamic interactions of the 3 essential stakeholders from a multidimensional perspective, and the mechanism of the interweaving of factors.

To Study Opportunities and Challenges of Big Data Analytics in Healthcare

Big data analytics in healthcare is a powerful tool that can bring about significant improvements in patient care, operational efficiency, and medical research. This study explores the various aspects of big data analytics in healthcare, aiming to uncover its many opportunities and challenges. Through a thorough review of existing literature and real-world case studies, this research highlights the potential benefits of big data analytics, such as better disease prediction, personalized treatment approaches, and optimized resource allocation. However, there are also notable challenges to overcome, including concerns about data privacy, problems with sharing information between different systems, and the need for skilled staff and strong infrastructure. By combining insights from different perspectives, this study provides a complete understanding of the current state of big data analytics in healthcare, offering valuable information for policymakers, healthcare professionals, and researchers to navigate this evolving field effectively.

Self-Assessment Instruments for Supporting Family Caregivers: An Integrative Review.

Family caregivers take on a variety of tasks when caring for relatives in need of care. Depending on the situation and the intensity of care, they may experience multidimensional burdens, such as physical, psychological, social, or financial stress. The aim of the present study was to identify and appraise self-assessment instruments (SAIs) that capture the dimensions of family caregivers' burdens and that support family caregivers in easily identifying their caregiving role, activities, burden, and needs. We performed an integrative review with a broad-based strategy. A literature search was conducted on PubMed, Google Scholar, Google, and mobile app stores in March 2020. After screening the records based on the eligibility criteria, we appraised the tools we found for their usefulness for family care and nursing practice. From a total of 2654 hits, 45 suitable SAIs from 274 records were identified and analyzed in this way. Finally, nine SAIs were identified and analyzed in detail based on further criteria such as their psychometric properties, advantages, and disadvantages. They are presented in multi-page vignettes with additional information for healthcare professionals. These SAIs have proven useful in assessing the dimensions of caregiver burden and can be recommended for application in family care and nursing practice.

Dimensions of living with emetophobia

Purpose This paper aims to present an examination of selected literature about the lived experiences of those with emetophobia. Its intention is to inform further empirical enquiry and subsequent approaches to treatment and care aimed at inclusive support for sufferers. To that end, it is important to bring the sufferers’ narrative into public and professional domains. Design/methodology/approach A systematic search of multiple databases using the search engine Discover@bolton and grey literature was undertaken to obtain evidence about the lived experiences of people with emetophobia. The search terms used were “emetophobia” and combinations of associated topic phrases using Boolean operators (AND / OR): “Emetophobia” OR “fear of vomiting” OR “fear of being sick”, Emetophobia AND “lived experiences” and finally Emetophobia OR “fear of vomiting” OR “fear of being sick” AND “lived experiences”. Eight papers were included in the review and five items of grey literature. Findings Several themes were identified in this literature including fear, escape and avoidance, other influences, consequences and medicalisation. The findings reveal that the experiences of those with emetophobia are subsumed beneath a focus on diagnosis and treatment. When it comes to understanding the actual lived experience of a person with emetophobia, the evidence presents the reader with what treatment may work and how they might respond to it, but largely omits the voice of the individual with emetophobia. This signals a need to undertake enquiry to bring this to the fore and so inform ways of greater inclusive practice for the public and professionals alike. Research limitations/implications The evidence reviewed in this paper can be noted for the limited discussion about the individual’s lived experience of emetophobia. Gaining insight into this would contribute to raising awareness in a wider public arena and inform carers and healthcare professionals’ understanding. It would also display the importance of an individual context and health journey. Practical implications Knowing this can inform approaches to helping an individual either to live with the phobia and manage its impact on daily living (positive rather than maladaptive coping mechanisms) or to overcome it with or without adjunct medical treatment (if this is possible). Social implications Knowing based on contemporary empirical enquiry will inform policy and guideline development. Whatever course is taken, it must contribute to steps being taken towards achieving a better quality of life for individual sufferers. The findings of this paper likewise inform the need for further study into the individual lived experience of emetophobia. Originality/value This paper is original in having identified a need to bring empirical evidence of the lived experience of sufferers with emetophobia into the public and professional domain.

"What Did You Say, ChatGPT?" The Use of AI in Black Women's HIV Self-Education: An Inductive Qualitative Data Analysis.

The emergence of widely accessible artificial intelligence (AI) chatbots such as ChatGPT presents unique opportunities and challenges in public health self-education. This study examined simulations with ChatGPT for its use in public education of sexual health of Black women, specifically in HIV prevention and/or HIV PrEP use. The research questions guiding the study are as follows: (a) does the information ChatGPT offers about HIV prevention and HIV PrEP differ based on stated race? and (b) how could this relatively new platform inform public health education of Black women educating themselves about sexual health behaviors, diagnoses, and treatments? In addressing these questions, this study also uncovered notable differences in ChatGPT's tone when responding to users based on race. This study described valuable insights that can inform health care professionals, educators, and policymakers, ultimately advancing the cause of sexual health equity for Black women and underscoring the paradigm-shifting potential of AI in the field of public health education.

High prevalence of erectile dysfunction in men with hyperthyroidism: a meta-analysis

ObjectiveThe objective of this study was to evaluate the association between hyperthyroidism and the risk of developing erectile dysfunction (ED).MethodsA comprehensive search of multiple databases, including PubMed, Embase, Cochrane, and Web of Science, was conducted to identify relevant studies investigating the relationship between hyperthyroidism and ED in men. The quality of the included studies was assessed using the Newcastle‒Ottawa Quality Rating Scale, and a meta-analysis was performed using Stata 16.0 and RevMan 5.3 software.ResultsA total of four papers encompassing 25,519 study subjects were included in the analysis. Among these, 6,429 individuals had hyperthyroidism, while 19,090 served as controls. The overall prevalence of ED in patients with hyperthyroidism was determined to be 31.1% (95% CI 0.06–0.56). In patients with uncomplicated hyperthyroidism, the incidence of ED was 21.9% (95% CI 0.05–0.38). The combined odds ratio (OR) for the four studies was 1.73 (OR: 1.73; 95% CI [1.46–2.04]; p < .00001).ConclusionOur findings demonstrate a higher incidence of ED in patients with hyperthyroidism. These results provide valuable information for healthcare professionals and can facilitate discussions surrounding appropriate treatment options for ED in patients with hyperthyroidism.

Molecular Detection of HPV, EBV, HSV-1, HCMV, and H. pylori Pathogens: An Evaluation among Polish Children with Molar Incisor Hypomineralization (MIH).

Molar incisor hypomineralization (MIH) is a congenital disorder of the enamel tissue, characterized by a quantitative deficiency. In childhood, infections such as EBV, HSV-1, HCMV, or H. pylori may occur and cause various diseases. This study aimed to investigate the prevalence of HPV, EBV, HSV-1, HCMV, and H. pylori infections in two groups of children: children with molar incisor hypomineralization (MIH) and a control group, using molecular methods. The study group included 47 children aged between 6-13 years who had been diagnosed with MIH. The control group consisted of 42 children. The study found that, in the MIH group, the prevalence of HPV-16 was 6.38%, HPV-18 was 4.26%, EBV was 31.91%, HSV-1 was 4.26%, HCMV was 4.26%, and H. pylori was 12.77%. There were no significant differences in the prevalence of any of tested pathogens between the study and the control group (p > 0.05). However, the study found a higher prevalence of EBV infection in children who had smallpox/pneumonia by the age of 3 years. Ten children were found to have at least two pathogens present. Moreover, both groups had a high prevalence and activity of EBV. These findings provide new insights into the carriage of pathogens among children with MIH, providing new information for parents, scientists, and healthcare professionals.

Patient-Centered Adult Cardiovascular Care: A Scientific Statement From the American Heart Association.

Patient-centered care is gaining widespread acceptance by the medical and lay communities and is increasingly recognized as a goal of high-quality health care delivery. Patient-centered care is based on ethical principles and aims at establishing a partnership between the health care team and patient, family member, or both in the care planning and decision-making process. Patient-centered care involves providing respectful care by tailoring management decisions to patients' beliefs, preferences, and values. A collaborative care approach can enhance patient engagement, foster shared decision-making that aligns with patient values and goals, promote more personalized and effective cardiovascular care, and potentially improve patient outcomes. The objective of this scientific statement is to inform health care professionals and stakeholders about the role and impact of patient-centered care in adult cardiovascular medicine. This scientific statement describes the background and rationale for patient-centered care in cardiovascular medicine, provides insight into patient-oriented medication management and patient-reported outcome measures, highlights opportunities and strategies to overcome challenges in patient-centered care, and outlines knowledge gaps and future directions.

Information and communication priorities of patients and healthcare professionals in shared decision making regarding adjuvant systemic breast cancer treatment: A survey study

PurposeTo assess information and communication priorities of patients and healthcare professionals in Shared Decision Making about adjuvant systemic treatment of primary breast cancer and identify key decision-relevant information accordingly. MethodsPatients (N = 122) and professionals working with breast cancer patients (N = 118), of whom 38 were nurse practitioners and 32 nurses, were recruited using convenience sampling, and surveyed about information/communication aspects key to decision-making, using ranking assignments. We further posed a simple open question, questions about receiving population-based statistics versus personalized statistics concerning treatment outcomes, and their attitude and experience concerning Shared Decision Making. Data were analyzed using descriptive analysis and a qualitative analysis. ResultsBoth patients and professionals prioritized information about treatment outcomes (i.e., survival, recurrence) as key decision-relevant information for patients. Patients prioritized information about relatively severe treatment side-effects and late effects (e.g., blood clot, stroke), whilst professionals prioritized information about effects that occur relatively often (e.g., hair loss, fatigue). Patients specifically wanted to know if the benefit of treatment is worth the negative impact. Both groups prioritized personalized statistics over population-based statistics. ConclusionsSome differences between patients and professionals were found in information and communication priorities, specifically related to the different side-effects. It seems worthwhile to precisely address these side-effects in Shared Decision Making concerning adjuvant systemic treatment. Furthermore, it seems important to deliberate together on the question if expected benefit of treatment is worth the potential negative impact for the individual patient.

Knowledge and Attitude Toward Otitis Externa: A Saudi Arabian Perspective

ABSTRACT Objectives: This study intended to assess the level of awareness and attitude toward otitis externa (OE) and specific limitations that counter the attempts to uplift the understanding and notion related to OE among the general population of Saudi Arabia. Methods: A cross-sectional quantitative study using a questionnaire was done via Google Forms between May 2023 and July 2023. The scoring method was used to determine the participant’s awareness or attitude; participants who scored &gt;50% were considered aware or to have a good attitude. Results: Approximately 52.2% had a good attitude toward the OE, and majority were willing to visit healthcare professionals (81%) to provide care and receive proper education during office visits (80.1%). Of all the participants, 69%, 33.4%, and 30.8% suggested that a lack of awareness, cost, and health insurance, respectively, might prevent patients from seeking a healthcare professional. Only 10.9% of participants demonstrated good awareness (score &gt;13) of outer ear inflammation. Conclusion: The findings indicate a poor level of awareness regarding OE, and a positive attitude toward seeking healthcare, with the majority recommending professional visits and relying on healthcare professionals for information.

Effects of Electronic Nicotine Delivery Systems Substitution on Body Weight Status: Protocol for a Systematic Review and Meta-Analysis.

Weight gain following smoking cessation is a well-documented concern, often attributed to the absence of nicotine's metabolic influence. The adoption of Electronic Nicotine Delivery Systems (ENDS) has been used to achieve smoking cessation, with claims of aiding weight control. However, existing reviews present conflicting conclusions on ENDS' impact on weight status, necessitating a rigorous evaluation. We aim to conduct a systematic review with meta-analysis to assess the actual impact of ENDS on weight status in individuals who have ceased or reduced conventional smoking. The primary goal is to provide clinicians with evidence-based insights into the potential effects of ENDS use as a smoking substitute on weight control. Adhering to PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines, our systematic review will analyze randomized and nonrandomized controlled trials, clinical trials (quasi-experimental), and prospective or retrospective cohort studies on the weight status effects of ENDS among individuals who have either quit or reduced smoking. Searches will include PubMed, Scopus, and Cochrane Library, covering the period from 2010 to January 2024. A gray literature search and supplementary searches will be performed. Data will be extracted independently by 2 reviewers and quality assessments will be conducted concurrently. Quality assessments will use Joanna Briggs Institute tools, 2020 version, along with bias assessments for internal validity and reporting bias based on the Catalogue of Bias. The included studies will be examined for any internal data reporting discrepancies by using Puljak's checklist. Meta-analysis and subgroup analyses (ie, general ENDS usage, ENDS use coupled with a reduction in smoking exceeding 50%, and exclusive ENDS use for achieving smoking cessation) are planned. Certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. The protocol has been registered in PROSPERO (CRD42023494974) and the entire systematic review is expected to be completed by April 2024. The main goal of this review is to retrieve all current human research studies investigating the influence of ENDS on weight management among individuals who have quit or reduced smoking. Furthermore, the review will assess the quality of these studies and examine potential biases to identify the most dependable evidence available. Dissemination strategies will include traditional journal publications, social media announcements, and a white paper. The latter, available for download and distributed at conferences, aims to reach a broad audience, including clinicians and ENDS users. The review will address the importance of informing health care professionals and patients about the current and robust evidence regarding the effects of transitioning to ENDS for smoking cessation on weight status. PROSPERO CRD42023494974; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=494974. PRR1-10.2196/56324.

Psychometric Testing of the Experience of Integrating Chronic Illness into Family Life Questionnaire.

Family members' experience of integrating chronic illnesses or chronic conditions into family life is valuable information for health care professionals, such as nurses, to understand, improve, and adjust the care provided to families of chronically ill patients. Furthermore, the assessment of the experience of integrating chronic illness into family life can support family nursing interventions and reduce suffering. This study aimed to adapt and psychometrically test a new Likert-type questionnaire on the experience of integrating pediatric chronic illness into family life (EICI-FLQ) in two European samples. A sample of 164 primary caregivers of children/adolescents with chronic illnesses/conditions in Iceland and another sample of 237 primary caregivers with children/adolescents with chronic illnesses/conditions in Portugal completed the online questionnaire. Exploratory factor analysis of the Icelandic sample yielded support for a one-factor solution with acceptable internal reliability (Cronbach's α = .866). Confirmatory factor analysis of the one-factor structure in the Portuguese sample indicated good model fit and similar internal reliability (Cronbach's α = .838). This instrument has good psychometric characteristics and is a promising tool for measuring the experience of integrating pediatric chronic illness into family life in clinical and research settings.

Impact of trans fatty acids on human health

The detrimental impact of trans fatty acids (TFAs) on human health has been extensively studied. This comprehensive review provides a critical analysis of the significant adverse effects of TFAs on human health. Moreover, a comprehensive evaluation of methods to reduce trans fatty acid consumption and enhance public health is provided. The paper emphasizes successful interventions performed at many levels, offering useful insights into viable strategies for tackling the urgent problem of harm caused by TFA. The compilation of evidence emphasizes the pressing need to reduce TFA intake in order to improve human health outcomes. This extensive analysis provides a significant source of information for politicians, healthcare professionals, and individuals who want to understand and tackle the various harmful effects of TFAs on human health. By increasing knowledge and offering scientifically supported suggestions, it enables individuals involved to make well-informed decisions in order to decrease trans fatty acid consumption and protect public well-being.

Evidence-informed and consensus-based statements about SAFEty of Physical Agent Modalities Practice in physiotherapy and rehabilitation medicine (SAFE PAMP): a national Delphi of healthcare scientific societies

ObjectiveA shared consensus on the safety about physical agent modalities (PAMs) practice in physiotherapy and rehabilitation is lacking. We aimed to develop evidence-informed and consensus-based statements about the safety of...

COMPARISON AND EXPLANABILITY OF MACHINE LEARNING MODELS IN PREDICTIVE SUICIDE ANALYSIS

ABSTRACT In this comparative study of machine learning models for predicting suicidal behavior, three approaches were evaluated: neural network, logistic regression, and decision trees. The results revealed that the neural network showed the best predictive performance, with an accuracy of 82.35%, followed by logistic regression (76.47%) and decision trees (64.71%). Additionally, the explainability analysis revealed that each model assigned different importance to the features in predicting suicidal behavior, highlighting the need to understand how models interpret features and how they influence predictions. The study provides valuable information for healthcare professionals and suicide prevention experts, enabling them to design more effective interventions and better understand the risk factors associated with suicidal behavior. However, it is noted the need to consider other factors, such as model interpretability and its applicability in different contexts or populations. Furthermore, further research and validation in different datasets are recommended to strengthen the understanding and applicability of the models in different contexts. In summary, this study significantly contributes to the field of predicting suicidal behavior using machine learning models, offering a detailed insight into the strengths and weaknesses of each approach and highlighting the importance of model interpretation for better understanding the underlying factors of suicidal behavior. Key words: Suicidal behavior prediction, Machine learning models, Neural network, Logistic regression, Decision tres, Explainability análisis, Healthcare intervention

Neurodevelopmental Outcomes for Individuals With Congenital Heart Disease: Updates in Neuroprotection, Risk-Stratification, Evaluation, and Management: A Scientific Statement From the American Heart Association.

Over the past decade, new research has advanced scientific knowledge of neurodevelopmental trajectories, factors that increase neurodevelopmental risk, and neuroprotective strategies for individuals with congenital heart disease. In addition, best practices for evaluation and management of developmental delays and disorders in this high-risk patient population have been formulated based on literature review and expert consensus. This American Heart Association scientific statement serves as an update to the 2012 statement on the evaluation and management of neurodevelopmental outcomes in children with congenital heart disease. It includes revised risk categories for developmental delay or disorder and an updated list of factors that increase neurodevelopmental risk in individuals with congenital heart disease according to current evidence, including genetic predisposition, fetal and perinatal factors, surgical and perioperative factors, socioeconomic disadvantage, and parental psychological distress. It also includes an updated algorithm for referral, evaluation, and management of individuals at high risk. Risk stratification of individuals with congenital heart disease with the updated categories and risk factors will identify a large and growing population of survivors at high risk for developmental delay or disorder and associated impacts across the life span. Critical next steps must include efforts to prevent and mitigate developmental delays and disorders. The goal of this scientific statement is to inform health care professionals caring for patients with congenital heart disease and other key stakeholders about the current state of knowledge of neurodevelopmental outcomes for individuals with congenital heart disease and best practices for neuroprotection, risk stratification, evaluation, and management.