The flipped classroom is an active methodology that has been implemented for many years in the training of nursing students with multiple studies published on this subject to date. This study sought to answer the question: is flipped classroom effective for improving nursing education? A systematic review of systematic and integrative reviews focused on studies that applied flipped classroom in the teaching of nursing students. Exhaustive literature searches were performed using five electronic databases: Medline, Cochrane, CINAHL Plus, Scopus and Web of Science. In total, 670 studies were identified, published from 2010 until 2020. Data were collected by two reviewers following the predesigned extraction form. Quality was assessed with the modified AMSTAR scale. A narrative synthesis of the findings has been used to present the results. 15 reviews (9 integrative reviews and 6 systematic reviews) were selected, comprising 274 studies, and providing a sample of 34,608 students. Most of the studies were conducted in China and the United States. A great heterogeneity and a medium-low methodological quality were detected. In the pre-class stage, individual instruction of students through reviews of articles and textbooks or electronic books is highlighted. In class, group activities were most frequently used, including assignments, presentations, projects, or discussion of topics, and in the post-class stage, course evaluation and self-study. The post-class stage was only recorded in two of the systematic reviews selected. When comparing the flipped classroom with the traditional methodology, better results were obtained in performance (k = 122), competencies (k = 92) and satisfaction (k = 10). The results suggest that the use of the flipped classroom in nursing education increases performance and is satisfactorily evaluated by both students and faculty. However, more studies are needed that meet methodological quality standards to consolidate the evidence.

Aims and Objectives: Evidence suggests that preparing patients for surgery using nonpharmacological strategies reduces their anxiety. However, there is no consensus on what the best practices are. This study aims to answer the question: Are interventions using nonpharmacological therapies effective in reducing preoperative anxiety?Background: Preoperative anxiety causes physiological and psychological adverse effects, with a negative effect on postoperative recovery.Introduction: According to the World Health Organization, between 266 and 360 million surgical procedures are performed annually worldwide, and it is estimated that more than 50% of patients will experience some degree of preoperative anxiety.Design: Systematic review of systematic reviews with results of interventions aimed at mitigating preoperative anxiety.Methods: A search was conducted for systematic reviews with meta‐analyses published between 2012 and 2021 in Medline, Scopus, Web of Science and Cochrane Library. Quality was assessed using the AMSTAR‐2 scale. The protocol was registered in PROSPERO.Results: A total of 1016 studies were examined, of which 17 systematic reviews were selected, yielding 188 controlled trials with 16,884 participants. In adults, the most common intervention included music, followed by massage, in children virtual reality and clowns. Almost all controlled trials reported a reduction in preoperative anxiety after the intervention, of which almost half had statistically significant results.Conclusion: Interventions that include music, massage and virtual reality reduce preoperative anxiety and have shown that they are cost‐effective, minimally invasive and with a low risk of adverse effects. Preoperative anxiety can be reduced through a short‐term intervention involving nursing professionals as an alternative or complement to drugs.Relevance to clinical practice: This review suggests that nursing professionals, in collaboration with other health professionals, should continue to conduct research on the reduction in preoperative anxiety. Further research in this area is needed, to reduce heterogeneity and consolidate the results.No Patient or Public Contribution: Not applied to our study, as it is a systematic review of systematic reviews.

There is a growing debate surrounding the contradiction between an unremitting increase in the use of resources and the search for environmental sustainability. Therefore, the concept of sustainable degrowth is emerging aiming to introduce in our societies new social values and new policies, capable of satisfying human requirements whilst reducing environmental impacts and consumption of resources. In this framework, circular economy strategies for food production and food loss and waste management systems, following the Sustainable Development Goals agenda, are being developed based on a search for circularity, but without setting limits to the continual increase in environmental impacts and resource use. This work presents a methodology for determining the percentage of degrowth needed in any food supply chain, by analyzing four scenarios in a life cycle assessment approach over time between 2020 and 2040. Results for the Spanish case study suggested a degrowth need of 26.8% in 2015 and 58.9% in 2040 in order to achieve compliance with the Paris Agreement targets, highlighting the reduction of meat and fish and seafood consumption as the most useful path.