Substance use is a widespread concern among young adults and is particularly significant among college students. Substance use in this population is associated with several academic, physical, mental, and social difficulties. This systematic review and metanalysis explores whether there is an effect of the legal and illegal substance and alcohol consumption behaviors on academic achievement among university students. The databases searched were MEDLINE, CINHAL, Scopus, ERIC, and PROSPERO, updated in January 2025. The risk of bias was assessed using the Edwards score. We used a random-effects model. The protocol of this review was registered in the Open Science Framework. The systematic review included 21 studies, while the meta-analysis included four studies. In a sample of 1,219 subjects in the control group and 350 legal and illegal substances consumers, there is a negative and significant association of substances consumption on academic achievement [SMD = − 0.61 (95% CI − 0.84 to − 0.38; p = 0.008). In a subgroup analysis, a sample of 2,479 subjects in the control group and 7,134 alcohol consumers, there is a non-statistically significative association of alcohol consumption on academic achievement [SMD = − 0.24 (95% CI -0.51 to 0.04; p = 0.073). Despite the limitations of this study, this systematic review provides quantitative evidence on the relationship between legal and illegal use of substances among university students and academic achievement. Specifically, we found a significant medium association of substance use in general and a small effect for alcohol consumption on academic achievement. Not applicable.

Objectives: This research aims to explore the perceptions of nursing students and directors of bachelor of nursing degree courses regarding reasons for attrition amongst nursing students. Methods: A qualitative descriptive study was conducted using inductive thematic analysis. The study included a purposeful sample of 12 students and 4 directors of bachelor of nursing degree courses. Results: As reasons for attrition, the directors highlighted a lack of preparation for nursing studies and students’ limited awareness of possibilities for support and learning. The students emphasized insufficient support from academic staff and poor course organization. Economic and family issues and a misunderstanding of the professional role of a nurse were cited as reasons by both directors and students. Conclusions: The findings provide important insight into attrition in the nursing programme. Further research is warranted, particularly in other contexts. Addressing student attrition requires a comprehensive approach that includes the provision of adequate support systems, mentorship, and resources for students.

Introduction: Home-based cardiac telerehabilitation (HBCTR) is a multidisciplinary intervention aimed at optimizing functional, psychological, and social recovery in patients undergoing percutaneous coronary intervention (PCI). This rehabilitation model serves as an effective alternative to traditional center-based rehabilitation, providing a cost-effective and clinically advantageous approach. Methods: Following PRISMA guidelines, we conducted a systematic literature search across multiple databases (PubMed, CINAHL, Cochrane, Scopus, Web of Science). We included randomized controlled trials (RCTs), cohort, and observational studies assessing telerehabilitation in post-PCI patients. Primary outcomes focused on health-related quality of life (HRQoL) and adherence, while secondary outcomes included functional capacity (6 min walk test, VO₂max), cardiovascular risk factor control, and psychological well-being. Risk of bias was assessed using the Cochrane RoB 2.0 and ROBINS-I tools. Results: A total of 3575 articles were identified after removing duplicates, of which 877 were selected based on title and abstract, and 17 met the inclusion criteria, with strong RCT representation ensuring robust evidence synthesis. HBCTR was associated with significant improvements in exercise capacity, with increases in VO₂max ranging from +1.6 to +3.5 mL/kg/min and in 6 min walk distance from +34.7 to +116.6 m. HRQoL scores improved significantly, with physical and mental component scores increasing by +6.75 to +14.18 and +4.27 to +11.39 points, respectively. Adherence to telerehabilitation programs was consistently high, often exceeding 80%, and some studies reported reductions in hospital readmissions of up to 40%. Wearable devices and smartphone applications facilitated self-monitoring, enhancing adherence and reducing readmissions. Several studies also highlighted improvements in anxiety and depression scores ranging from 10% to 35%. Conclusions: HBCTR is a promising strategy for rehabilitation and quality-of-life improvement after PCI. It offers a patient-centered solution that leverages technology to enhance long-term outcomes. By integrating structured telerehabilitation programs, healthcare systems can expand accessibility, promote adherence, and improve equity in cardiovascular care.

Background: Moral Distress (MD) is a unique form of distress that occurs when people believe they know the ethically correct action to take but are constrained from doing so. Limited clinical experience and insufficient ethical knowledge contribute to nursing students’ MD, which can potentially cause negative outcomes. The aims of this study are: (1) to describe the MD intensity of nursing students, and (2) to analyze differences and associations between MD intensity and socio-demographic and academic variables. Methods: A cross-sectional study design with a convenience sample of the second, third, and delayed graduation students was included; only students willing to participate and who had attended their scheduled internships in the last six months were eligible for inclusion. To measure the level of MD, we used the It-ESMEE. We collected socio-demographic and academic variables. The data collection occurred from January 2024 to March 2024. Results: The students who adhered to the collection were N = 344. The findings reveal that the students perceived a high level of MD in situations related to clinical internship and class. They perceived higher levels of MD when nursing was not their first career choice, were separated or divorced, did not have children, and were not an employed student. The overall MD score is statistically significantly lower among students who had nursing as their first career choice (β = −0.267, p < 0.05), have children (β = −0.470, p < 0.01), and are employed (β = −0.417, p < 0.01). In contrast, being separated or divorced (β = 0.274, p < 0.01) was associated with a higher MD score. Conclusions: This study has some limitations: data reflect a local context, and the findings may not be generalizable to other regions or educational environments. Additionally, students’ recollections of their experiences could be influenced by the passage of time, and there may be a selection bias since only students willing to participate were included. The findings suggest that nursing education programs should incorporate more robust training in ethical decision-making and stress management to better prepare students for the moral challenges in their professional practice.

Background/Objectives: Satisfaction among undergraduate nursing students plays a crucial role in student retention, helping to mitigate nursing shortages in the workforce, reduce academic costs, and uphold universities’ reputations. The Nursing Student Satisfaction Scale (NSSS) measures three theoretical domains: Professional Social Interaction, Curriculum and Teaching, and Learning Environment. Although the NSSS has demonstrated reliability and validity with respect to American nursing students, its psychometric properties have not been tested on a population of Italian nursing students. Therefore, this study aimed to determine the reliability and validity of the NSSS in regard to Italian nursing students. Methods: A multicenter observational study was conducted on undergraduate nursing students in Central Italy. A confirmatory approach was used to assess structural validity. The construct validity, internal consistency, test–retest reliability, and responsiveness to change of the NSSS were evaluated using correlation analyses, reliability coefficients, and measurement error determination. Results: Confirmatory factor analysis supported the three-factor first-order structure of the NSSS as well as the presence of a single second-order factor. Reliability was adequate for all the coefficients computed (with values ranging from 0.924 to 0.974). Construct validity was supported. The measurement error was adequate. Conclusions: The NSSS exhibited robust measurement properties, confirming its validity and reliability as an instrument for assessing nursing student satisfaction in the Italian context. Furthermore, our results indicate that, after the translation and cultural adaptation of the scale, the construct of nursing student satisfaction remains consistent with the theoretical model.