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Exploring quality of life among elderly persons living with HIV in Accra, Ghana

Introduction The introduction and rapid scale-up of AntiRetroviral Treatment (ART) has contributed to a significant reduction in HIV-associated morbidities and mortalities, resulting in increasing life expectancy. Ageing with HIV presents several challenges which affect peoples’ well-being and quality of life (QoL). Despite this, there is scarcity of research on the QoL of Elderly Persons Living with HIV (EPLHIV) in Sub-Saharan Africa (SSA), particularly in Ghana. This study, therefore, examines the QoL of the elderly population using a qualitative approach. Methods A purposive sampling method was used to select eight (8) participants for Key Informant Interviews (KIIs) and twenty-nine (29) participants for Focus Group Discussions (FGDs). In all, eight (8) KIIs with stakeholders and four (4) FGDs with EPLHIV were used to collect data for this study. Both the KIIs and FGDs interview guides addressed the four domains of the WHO’s Quality of Life (WHOQoL) Bref assessment tool; physical, psychological, social, and environmental health with the overall focus on evaluating quality of life. The data was analysed thematically using QSR NVivo 11. Results Of the 37 participants, majority (54%) of them were females, and a considerable proportion (94%) had attained formal education. The most prolonged duration of persons living with HIV among the respondents was 25 years. Four main themes were identified: physical health, social well being, environmental health, and psychological health. The study further revealed that EPLHIV reflect on their condition, face the dilemma of disclosing their status, are confronted with inadequate privacy for health care, wait long in the queue at the health facilities to be attended to, and have no focused or tailored HIV services for the EPLHIV and experiences worsened physical conditions. Conclusions The study’s findings shed light on the quality of life among EPLHIV, offering new evidence. Consequently, some of the conditions related to the various domains such as stigma, delay in receiving health care could negatively influence the QoL of EPLHIV. To improve the QoL of EPLHIV, it is imperative to implement specialized services tailored to the unique needs of EPLHIV. Additionally, healthcare workers at ART clinics should receive training in psychological and geriatric care counseling, considering the increasing life expectancy of EPLHIV. There should be counseling sessions on disclosure and non-disclosure to help those who want to disclose their status do so.

Serum hyaluronic acid in critically ill dogs and influence of intravenous fluid therapy

Background The endothelial glycocalyx (EG) appears to play a critical role in physiological vasculo-endothelial function. Sepsis, trauma, and hemorrhagic shock are associated with EG shedding and intravenous fluids have the potential to worsen EG degradation. There is little available research evaluating the relationship between intravenous fluids, inflammation, and EG degradation in critically ill dogs. Objective To study EG degradation in critically ill dogs over their first 48 hours of hospitalization and characterize the influence of intravenous fluids and inflammation. Methods Hyaluronic acid (HA), a biomarker of EG degradation, was measured in dogs with non-pulmonary sepsis, pulmonary sepsis, or spontaneous hemoperitoneum at five pre-defined time points over 48 hours. The concentration of HA was trended over time, compared between groups, and studied for associations with the cumulative volume of intravenous fluids administered, a pro-inflammatory cytokine (interleukin-6, IL-6), and a biomarker of hypervolemia (atrial natriuretic peptide, ANP). Results Concentration of HA was not significantly different between the groups at each time point. It increased over the first 24 hours of the study before reaching a plateau in patients with sepsis and spontaneous hemoperitoneum. Concentration of IL-6 had a significant positive association with HA concentration on presentation in all groups (p = 0.026). Cumulative fluid volume had a significant association with HA concentration during hospitalization in all groups (p = 0.0002). There was no significant effect of ANP on HA concentration. Concentration of HA was associated with disease severity but not with outcome. Conclusions In the dogs studied, markers of inflammation and administration of larger volumes of intravenous fluids were associated with increasing HA concentration, and thus presumptive EG degradation. Further research is needed to explore the clinical impact of intravenous fluid therapy on the EG. These findings should be considered carefully by clinicians prescribing fluid resuscitation for critically ill dogs.

Genetic variations associated with adaptation in Acrocomia palms: A comparative study across the Neotropics for crop improvement

Population genetic research has evolved, focusing on selection processes using single nucleotide polymorphisms (SNP) genotyping techniques to study crop traits and domestication. This study explores the adaptation process of three neotropical palms of Acrocomia , a genus that has high potential for oil extraction. Our research focused on their genetic structure, evolutionary significance, and implications of the selection signatures for breeding efforts. We employed genotyping-by-sequencing (GBS) focusing on outlier SNP markers to identify adaptive genes in A. aculeata , A. totai , and A. intumescens across their entire distributions. Our results reveal two major gene pools in A. aculeata : a Central American group and a South American group, mainly influenced by dispersal and biogeographic barriers. Putative selective signatures were identified in candidate genes associated with traits related to oil biosynthesis, pathogen resistance, and adaptation to environmental stress like drought tolerance. A. totai exhibited a pronounced genetic structure influenced by distinct biomes, suggesting recent diversification driven by climatic and geological factors, particularly within the Pantanal biome. A. intumescens displays genetic structuring shaped by the endemic process of biogeographic barriers within the Caatinga biome . Correlations between allele frequencies and climatic variables highlight adaptation to diverse environments, with the annual mean temperature and precipitations being one of the most influential. Candidate genes associated with fatty acid and carotenoid biosynthesis, as well as pathogen resistance and drought tolerance, indicate targets for future breeding studies. Despite the challenges associated with reduced representation sequencing, this study highlights the potential for gene discovery in Acrocomia , offering promising targets to enhance oil yield productivity. Future efforts should prioritize whole-genome sequencing and genotype-environment interaction studies to realize the full potential of Acrocomia spp. in sustainable oil production.

Cost-effectiveness analysis of adebrelimab in combination with chemotherapy for first-line treatment of extensive-stage small cell lung cancer

Objective This study aims to assess the cost-effectiveness of adebrelimab in combination with chemotherapy as a first-line treatment for extensive-stage small cell lung cancer (ES-SCLC) from the Chinese medical perspective. Methods We have designed a partitioned survival model. The model integrates clinical information pertaining to overall survival, progression-free survival, adverse events and cost data. Our primary measure of outcome in this model is quality-adjusted life years (QALY) and the incremental cost-effectiveness ratio (ICER). The model adopted a willingness to pay (WTP) threshold of $40,343.68 per QALY. To account for uncertainty in the model parameters, we conducted sensitivity analyses. Results The total expenditure for the adebrelimab group was $79,549.34, compared to $6,436.80 for the chemotherapy group. The adebrelimab cohort achieved an incremental gain of 1.25 QALY, resulting in an additional cost of $73,112.54. Consequently, the ICER for the adebrelimab group was determined to be $58,490.03 per QALY, surpassing the WTP threshold of $40,343.68 in China. The sensitivity analyses demonstrated the robustness of the findings across various scenarios. Conclusion This cost-effectiveness analysis indicates that adebrelimab plus chemotherapy as a first-line treatment for ES-SCLC was not cost-effective in China with a WTP of $40,343.68.Reducing the cost of adebrelimab promises to improve the cost-effectiveness of this treatment regimen.

Prevalence and aeroallergen sensitization in pediatric Allergic Rhinitis: A population-based study in Jeju, Korea

Allergic rhinitis (AR) is a prevalent chronic disease among children, influenced by environmental and genetic factors. Understanding regional aeroallergen sensitization patterns is essential for targeted intervention. This study investigates the prevalence of AR and its associated aeroallergen sensitization among schoolchildren in Jeju, Korea. A cross-sectional, population-based study was conducted in 2016 on 1,067 schoolchildren aged 9–16 years. Data were collected using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and skin prick tests for 18 common aeroallergens. Statistical analysis was performed using multiple logistic regression to determine risk factors for AR. The prevalence of AR was 29.0%, with the highest sensitization rates observed for Dermatophagoides pteronyssinus (76.5%), Dermatophagoides farinae (60.9%), and Japanese cedar pollen (39.1%). Sensitization to multiple aeroallergens (polysensitivity) was significantly associated with increased AR risk (OR 1.58, 95% CI: 1.017–2.455, p = 0.042). Age-related variations in sensitization patterns were noted, with younger children showing higher overall sensitization rates. This study provides evidence of region-specific allergen sensitization patterns in pediatric AR. The high prevalence of Japanese cedar pollen sensitization highlights the need for further investigation into environmental exposure and potential preventive measures.

Impact of iSupport on improving knowledge on dementia and dementia care among family caregivers to persons with dementia and formal caregivers in Bangladesh: Protocol for a non-randomized feasibility study

Dementia is a growing global public health concern, particularly in LMICs like Bangladesh. With population aging, there is an increasing prevalence of dementia; care facilities are limited. This scarcity of services places a significant responsibility on untrained family caregivers, impacting the health of persons with dementia and their caregivers. Addressing these challenges is crucial for improving dementia care, especially in resource-constrained settings. Recognizing the urgency, the WHO developed an online self-training manual, iSupport, emphasizing education, skill development, and support for caregivers. This study aims to test feasibility of iSupport i) in improving knowledge about dementia and dementia care among family and formal caregivers, and ii) reducing family caregivers’ stress and improving their caregiving skills, mental health, quality of life and relationship with the person with dementia cared for. The study protocol was approved by the Institutional Review Board of SAJIDA Foundation (2024–005-SFIRB). This non-randomized feasibility study aims to recruit 44 family caregivers and 132 formal caregivers from Dhaka, Bangladesh, using a purposive sampling technique. Participants will be provided access to iSupport for two months. Pre- and post-intervention surveys will be conducted to assess changes in knowledge about dementia care among both family and formal caregivers, as well as changes in psychological well-being among family caregivers. To assess knowledge retention, a follow-up survey will be conducted. Any differences in the outcomes from the pre-intervention period will be tested against the null hypothesis of zero mean difference using a two-sample paired t-test. Additionally, multivariable regression techniques will also be used to control for possible confounders. To understand the facilitators and barriers of implementing iSupport, a qualitative approach will be used to interview 15 family caregivers and conduct four FGDs with formal caregivers. Qualitative data will be analysed using an inductive content analysis approach.

Evaluating the predictive value of frailty scores for critical care admission and hospital stay in elderly surgical patients: A comparison of the mFI-5 and CCI

Background Frailty is a critical determinant of postoperative outcomes in elderly patients. Several frailty assessment tools, including the Modified Frailty Index (MFI-5) and the Charlson Comorbidity Index (CCI), have been proposed to predict complications, hospital length of stay (LoS), and critical care admission. However, their comparative predictive value across a broad spectrum of non-cardiac surgeries remains unclear. The purpose of this study was to assess the predictive ability of MFI-5 and CCI in predicting critical care admission and length of stay (LoS). Methods This single-centre retrospective study analysed data from patients over 65 years of age who attended the preoperative assessment clinic at the Mater Misericordiae University Hospital (MMUH), Dublin, between November and December 2023. MFI-5 and CCI scores were calculated, and their ability to predict hospital LoS (>5 days) and critical care admission was assessed using area under the receiver operating characteristic curve (AUROC) analysis. Results Data from 100 patients were included. Critical care admission was required for 20 patients, and the average hospital length of LoS was 4.5 days. AUROC analysis demonstrated that neither the MFI-5 nor CCI were predictive of critical care admission or extended LoS in this cohort. Conclusion The findings suggest that MFI-5 and CCI alone may not be sufficient to predict critical care admission or hospital LoS in elderly patients undergoing non-cardiac surgery. Given the multifactorial nature of postoperative risk, future models integrating frailty indices with surgical and anaesthesia-specific factors may enhance predictive accuracy, improve risk stratification, and optimize perioperative resource allocation.

Sentinel NOSE: Prospective feasibility study on sentinel lymph node biopsy in bulky nasal vestibule cancer

Objective Patients with bulky squamous cell carcinoma of the nasal vestibule are at high risk of nodal relapse and have worse prognosis, despite modern neck imaging. More sensitive assessment of the neck may obviate elective treatment and ultimately reduce the risk of nodal relapse and improve outcome. The goal of this study was to evaluate the feasibility, safety and tolerability of sentinel lymph node biopsy (SLNB) in staging of bulky squamous cell nasal vestibule carcinoma (NVC). Methods Ten patients with cT1-T2N0 squamous cell NVC with diameter ≥1.5 cm, planned for curative brachytherapy, were prospectively included to undergo four peritumoral injections of ICG-[99mTc]Tc-nanocolloid. Subsequently, dynamic, static and SPECT/CT images were performed. The following day SLNB was conducted under general anesthesia combined with brachytherapy implantation of the primary tumor. Results Sentinel lymph nodes were visualized in all patients (median 3.5 per patient), with successful subsequent biopsy in all cases (median yield 2.5 per patient). Occult lymph node metastases were found in 50% of patients. The procedure was well-tolerated. Conclusion SLNB in bulky NVC is feasible and safe, with a high success rate of executing the SLN procedure. The relatively high incidence of occult metastases in this population is consistent with earlier findings. Further research is needed to quantify the impact of SLNB in terms of total treatment burden and oncological outcomes.

ComplexityMeasures.jl: Scalable software to unify and accelerate entropy and complexity timeseries analysis

In the nonlinear timeseries analysis literature, countless quantities have been presented as new “entropy” or “complexity” measures, often with similar roles. The ever-increasing pool of such measures makes creating a sustainable and all-encompassing software for them difficult both conceptually and pragmatically. Such a software however would be an important tool that can aid researchers make an informed decision of which measure to use and for which application, as well as accelerate novel research. Here we present ComplexityMeasures.jl, an easily extendable and highly performant open-source software that implements a vast selection of complexity measures. The software provides 1638 measures with 3,841 lines of source code, averaging only 2.3 lines of code per exported quantity (version 3.7). This is made possible by its mathematically rigorous composable design. In this paper we discuss the software design and demonstrate how it can accelerate complexity-related research in the future. We carefully compare it with alternative software and conclude that ComplexityMeasures.jl outclasses the alternatives in several objective aspects of comparison, such as computational performance, overall amount of measures, reliability, and extendability. ComplexityMeasures.jl is also a component of the DynamicalSystems.jl library for nonlinear dynamics and nonlinear timeseries analysis and follows open source development practices for creating a sustainable community of developers and contributors.

Effect of active follow-up of women with previous cesarean delivery on uptake of timely safe obstetric and surgical care: Comparison between pre-intervention and intervention cohorts in Rwanda

Introduction The rate of cesarean delivery (CD) in Rwanda has increased significantly from 2.2% in 2000 to 15.6% in 2020. Given increasing risks in subsequent pregnancy following CD it is important that women who have had a prior cesarean section plan and schedule CD in later pregnancies. This study assessed the effectiveness of the USAID MOMENTUM Safe Surgery in Family Planning and Obstetrics intervention in reducing emergency CDs among women with previous CDs. Methods We conducted a cohort study in four public hospitals and 64 health centers across Rwanda, comparing two non-parallel cohorts: a pre-intervention cohort (December 2021–February 2022) and an intervention cohort (November 2022–May 2023). Exploratory data analysis and logistic regression were conducted to analyze the emergency CD rate and any associated factors. Results The pre-intervention group comprised 212 women, whereas the intervention group involved 283 women, of whom 189 were included in the analysis. Among the 189 women in the intervention group, 87.3% reported to the hospital within five days post-referral when they were first called. The percentage of women who consulted for a delivery plan within 36–38 weeks of gestation increased from 37.6% in the pre-intervention group to 62.4% in the intervention group. Consequently, in the adjusted logistic regression model, there was still a significant association between the intervention and reduced odds of emergency CD, with a 81% reduction in the odds of delivery by emergency CD (0.187; 95% CI: [0.115; 0.298]) compared to pre-intervention. Conclusion This study demonstrates the effectiveness of an active follow-up intervention in promoting delivery planning and reducing emergency CD rates among pregnant women with previous CD scars. The comprehensive intervention, including tailored education and personalized phone conversations around the delivery period, appears to have contributed to increased awareness and motivation for women to seek timely care at the hospital for delivery planning.

Resolving spatial subclonal genomic heterogeneity of loss of heterozygosity and extrachromosomal DNA in gliomas

Mobilizing human capital in information technology projects: Interactions, negotiations, and actions of distributed actors

The study explores the interaction of two cross-functional distributed actors (HR and project managers), their actions, and how they utilize existing practices to mobilize human capital in projects. The study, located at the intersection of practitioners and praxis, explores how the flow of different HR activities is constructed during project execution. Based on extensive field-based qualitative research and anchored on the micro foundations’ lens, we find that paired distributed actors (project manager and HR manager) engage in two mutually exclusive strategizing practices (human resource procedurally embedded and human resource interactive and mutual) for shaping the activity flow of HRM implementation. This finding is critical because it explains how the tension between the paired distributed actors is handled during project execution in project-based firms.

The archaeology of climate change: a blueprint for integrating environmental and cultural systems

Abstract Cultural systems play an important role in shaping the interactions between humans and the environment, and are in turn shaped by these interactions. However, at present, cultural systems are poorly integrated into the models used by climate scientists to study the interaction of natural and anthropogenic processes (i.e. Earth systems models) due to pragmatic and conceptual barriers. In this Perspective, we demonstrate how the archaeology of climate change, an interdisciplinary field that uses the archaeological record to explore human-environment interactions, is uniquely placed to overcome these barriers. We use concepts drawn from climate science and evolutionary anthropology to show how complex systems modeling that focuses on the spatial structure of the environment and its impact on demographic variables, social networks and cultural evolution, can bridge the gap between large-scale climate processes and local-scale social processes. The result is a blueprint for the design of integrative models that produce testable hypotheses about the impact of climate change on human systems.

Evaluating turnaround time to improve clients’ satisfaction in the tuberculosis reference laboratory in Douala

Introduction Delivery delays of laboratory results can result in death and/or economic loss to both the patient and the health system. Data is limited regarding turnaround time for tuberculosis testing in Cameroon. We evaluated intra- turnaround time in tuberculosis diagnosis, identified root causes, and brainstormed solutions to improve patient satisfaction. Materials and methods In this cross-sectional descriptive study, turnaround time for the pre-analytic phase was set at 3 hours, the analytic phase at 11 hours, and the post-analytic phase at 10 hours. The overall turnaround time was 24 hours. We used the Fishbone method of problem analysis involving the personnel of the Tuberculosis Reference Laboratory-Douala, to identify root causes. We brainstormed using the “Whys” causes of turnaround time failure during the process of tuberculosis diagnosis by GeneXpert MTB/RIF Results We analyzed samples from 526 clients. The median turnaround time was 45 (Range: 2-120) hours. A total of 216(41.1%) clients had a turnaround time failure. The turnaround time failures in the pre-analytic, analytic, and post-analytics phases were 64(29.6%), 128(59.3%), and 12(11.1%) respectively. Overall, 19 root causes of turnaround time failure were identified and grouped into six categories, namely: equipment, administration, technical-staff, environment, material, and method. Equipment maintenance (defective or non-calibrated modules) was the critical cause of turnaround time failures accounting for 86 (39.8%) of the overall turnaround time failure. Conclusion turnaround time in tuberculosis diagnosis is longer than expected, retarding patient care management. Focusing on equipment maintenance enhances the intra-laboratory testing process, thus improving overall patient satisfaction. The need for further studies to incorporate the extra-laboratory turnaround time in assessing the overall turnaround time is imperative.

Correction: Cognitive effort investment: Does disposition become action?

Randomization in clinical trials with small sample sizes using group sequential designs

Background: Group sequential designs, which allow early stopping for efficacy or futility, may benefit from balanced sample sizes at interim and final analyses. This requirement for balance limits the choice of admissible randomization procedures. We investigate if the choice of randomization procedure, whether balanced or not, impacts the type I error probability and power in small sample clinical trials with group sequential designs. Methods: We start with a literature review to assess how randomization procedures are reported in group sequential trials. We then investigate the impact of randomization procedures on the type I error probability and power of trials with Pocock, O’Brien-Fleming, Lan-DeMets and inverse normal combination test designs. Results: Our findings show that only a limited number of published group sequential trials report sufficient randomization details. Simulation results demonstrate that deficiencies in the implementation of randomization can inflate type I error rates. Some combinations of group sequential designs and randomization procedures cause a loss of power, for example, when using inverse normal combination tests. When the planned balanced allocation ratio in (interim) analyses cannot be ensured, the Lan-DeMets approach is preferable for small sample trials due to its robustness to deviations between the planned and observed allocation ratio. The inverse normal combination test, while useful in trials with limited prior information, should be used cautiously with permuted block randomization that maintains the planned allocation ratio to avoid power loss. Conclusion: We propose a framework for selecting the most suitable combinations of group sequential design and randomization procedure for small sample clinical trials. Our findings highlight the need for improved reporting of randomization methods in group sequential clinical trials. Further, the validity of some of the group sequential designs relies on the application of appropriate randomization procedures which were difficult to identify in the literature and is possibly violated.

The role of control in precipitating and motivating self-harm in young people: A systematic review and meta-synthesis of qualitative data

The last decade has seen a steady rise in self-harm rates in young people in developed countries. Understanding the experience of self-harm in young people can provide insight into what may be driving this increase. The aim of the current review was therefore to synthesise qualitative research examining precipitating and motivating factors underlying self-harm in young people. PsychInfo, Embase and Medline were systematically searched for articles published up to September 2024. A total of 50 qualitative studies (study N ranging from 3–115) were identified, and key findings were synthesised using Attride-Stirling’s Thematic Network Analysis process. The quality of included studies was assessed using a modified version of two Joanna-Briggs Institute Checklists. Control was identified as a global theme. Precipitants were informed by young people’s perception of an absence of control and the desire to gain control was identified as an underlying motivation for self-harm. The findings from this review highlight the need to support and educate young people to improve their distress tolerance, particularly in respect to situations outside of their control. Furthermore, therapeutic interventions, and training and educational programs targeting young people who self-harm and their family members might be effective interventions for self-harm in young people.

Correction: ADHD and family life: A cross-sectional study of ADHD prevalence among pupils in China and factors associated with parental depression

Associations of tongue and hyoid position, tongue volume, and pharyngeal airway dimensions with various dentoskeletal growth patterns

Objective This study investigated the association between tongue and hyoid position, tongue volume, and pharyngeal airway dimensions with craniofacial growth patterns in the sagittal, vertical, and transverse planes. Methods Cone beam computed tomography was used to assess 185 non-growing subjects (mean age, 28.7 ± 9.5 years). Multivariate linear regression analyses evaluated relationships between tongue and airway variables, and cephalometric/dental arch measurements. Results Class III skeletal patterns—reflected by lower ANB and higher APDI—were significantly correlated with anteriorly positioned hyoids (ANB: β = 0.249; APDI: β = –0.291), and lower tongue positions at the tongue tip (ANB: β = –0.231; APDI: β = 0.166) and in the posterior area (ANB: β = –0.186; APDI: β = 0.196), and greater tongue volume (APDI: β = 0.174). Hyperdivergent vertical patterns—indicated by a lower ODI—were significantly correlated with a lower tongue tip position (β = –0.311) and posterior tongue position (β = –0.230). Regarding transverse dimensions, tongue volume showed positive correlations with upper intermolar width (β = 0.349), lower intercanine width (β = 0.130), lower intermolar width (β = 0.311), and a negative correlation with upper intercanine width (β = –0.299). Conclusions Sagittal and vertical craniofacial patterns are interrelated and show associations with tongue and hyoid position, as well as tongue volume. Transverse dental arch dimensions are correlated not only with tongue position and volume but also with pharyngeal airway volume.

Can the development of cooking skills influence nutritional status and diet in healthy adults? A systematic review and meta-analysis protocol

Cooking skills are defined as the individual knowledge, confidence, and attitude required to perform culinary tasks, which have been studied as a strategy to improve diet and health outcomes. This article describes a systematic review and meta-analysis protocol aiming to assess whether whether intervention-based development of cooking skills improves dietary quality or nutritional status in healthy adults. The protocol follows the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols [PRISMA-P] and has been registered in the International Prospective Register of Systematic Reviews database (PROSPERO: CRD42022385234). Search strategies will be developed based on the combination of descriptors and executed in the PubMed, Embase, Scopus, Web of Science, and SciELO databases. Only intervention studies linking cooking skills to dietary outcomes will be included. Two trained researchers will independently select articles, extract data, and assess the risk of bias. The methodological quality of the studies will be evaluated using the Cochrane Risk Of Bias In Non-randomized Studies – of Interventions [ROBINS-I] and the Cochrane Risk-of-Bias tool for randomized trials (RoB 2). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework will be employed to assess the quality of evidence. Implementing this protocol will result in the development of a systematic review assessing whether the enhancement of cooking skills can influence the nutritional status and diet of healthy adults. Systematizing this knowledge is important to understanding cooking skills not only as a therapeutic tool when pathologies are present but also as a health prevention strategy. Therefore, the systematic review based on this protocol may contribute to the formulation of effective public health policies aimed at improving nutritional status and diets through the development of cooking skills, thus helping prevent adverse health outcomes such as cardiovascular diseases, diabetes, and obesity.