Background/Objectives: Human papillomavirus (HPV) is a leading cause of cervical cancer. Despite the proven effectiveness of vaccination programs, global coverage remains uneven, with significant disparities across regions due to various socioeconomic, cultural, and political factors. This study explores the primary barriers to HPV vaccination worldwide and proposes recommendations to improve access to screening and vaccination programs. Methods: A systematic literature review was conducted, analyzing studies published in the past ten years from databases such as PubMed, Scopus, and Embase, following the PRISMA methodology. Study selection involved multiple researchers, with discrepancies resolved through consultation. The quality of the included studies was assessed using CASP checklists. The protocol was registered on Open Science Framework (OSF). Results: Out of 2119 records, eight studies were included. The findings indicate that the main barriers to HPV vaccination include insufficient public awareness, cultural and religious resistance, financial constraints, and limited access in rural and underserved areas. Additionally, political factors, such as low prioritization of HPV vaccination and the absence of supportive policies, were identified as significant obstacles. Multidisciplinary and cross-cultural collaboration, along with the integration of HPV vaccination into existing health programs, was suggested as a strategic approach to improve vaccine uptake. Conclusions: Barriers to HPV vaccination, including limited awareness, inadequate healthcare infrastructure, and socioeconomic factors, vary across regions but must be addressed to improve global coverage. Targeted interventions such as health education, inclusive policies, and culturally sensitive campaigns can significantly boost vaccine uptake. Strengthening local health systems and fostering international collaboration are key strategies to overcoming these barriers and ensuring equitable access to HPV vaccination.

Introduction: Pressure ulcers (PUs) represent a significant challenge in chronic care, particularly among the elderly with reduced mobility. They result in substantial socio-healthcare costs and negatively impact patients’ psychological well-being. Malnutrition is a key risk factor, hindering healing and increasing the risk of complications. As such, appropriate nutritional interventions are crucial for managing PUs. However, these interventions are often underestimated in clinical practice, underscoring the need for a more comprehensive approach to elder care and healthy aging. Objectives: The primary objective of this study was to identify the best scientific evidence on nutritional interventions implemented by nurses in community settings to prevent complications related to PUs. Additionally, qualitative and quantitative outcomes reported in the included studies were analyzed. Method: This systematic review was conducted following PRISMA international guidelines. Searches were performed in PubMed, Scopus, Embase, and CINAHL databases. A predefined search strategy using Boolean operators was employed, and two researchers independently selected papers, with a third researcher resolving any discrepancies. Additional sources and manual reviews were conducted to minimize selection bias. Results: Out of 1003 records, 6 studies were included. Findings indicate that nurses play a fundamental role in managing PUs in community settings through specific nutritional intervention assistance processes. These healthcare professionals are pivotal in the prevention, care, and rehabilitation of vulnerable individuals with PUs. Conclusions: Nurses are strategic in the management of PUs within community care for frail populations. With nutritional support that plays a key role in both preventing and accelerating the healing of PUs. Policymakers are encouraged to invest in nursing roles to enhance assistance in community contexts, supporting healthy aging and lifestyle medicine approaches.

Starting Active Materials for Synthesis (SAMS) represents a critical stage in drug manufacturing, directly influencing the microbiological quality and safety of the final product. The introduction of SAMS marks the point where Good Manufacturing Practices (GMP) begin to apply, which are essential for ensuring sterility and preventing microbial contamination during the synthesis process. However, defining the exact point in the process that qualifies as the SAMS is subject to uncertainties, as earlier stages are not always governed by stringent GMP standards. The regulatory differences between various countries further contribute to this issue. This study explores the implications of SAMS selection and use in relation to sterility and infection control, analyzing the guidelines of major Regulatory Authorities and comparing their approaches to GMP. Regulations from several international regulatory agencies were examined, with a particular focus on microbiological control measures and infection protection in the SAMS manufacturing process. The analysis focused on the microbiological control requirements and safety measures applicable to the stages preceding the introduction of SAMS into the production of the final Active Pharmaceutical Ingredients (APIs). Documents published between 2015 and 2025 were included based on predefined criteria regarding relevance, accessibility, and regulatory authority. The analysis revealed significant discrepancies between regulations regarding the definition and management of SAMS. In particular, the regulations in Mexico and India have notable gaps, failing to provide clear guidelines on SAMS sterility and protection against infectious contamination. Conversely, China has introduced risk-based approaches and early-stage microbiological controls, especially for sterile products, aligning with international standards. The European Medicines Agency (EMA), the U.S. Food and Drug Administration (FDA), the Pharmaceutical Inspection Co-operation Scheme (PIC/S), and the World Health Organization (WHO) have well-established systems for microbiological quality control of SAMS, including rigorous measures for the validation of suppliers and risk management to ensure that SAMS does not compromise the microbiological safety of the final product. The regulations in Brazil and Canada introduce additional measures to protect the microbiological quality of SAMS, with specifications for contamination control and certification of critical stages. The lack of a harmonized language for the definition of SAMS, coupled with a fragmented regulatory framework, presents a challenge for infection protection in pharmaceutical manufacturing. Key issues include the absence of specific regulations for stages prior to the introduction of SAMS and the lack of standards for inspections related to these stages. A desirable solution would be the mandatory extension of GMPs to the stages before SAMS introduction, with centralized control to ensure sterility and protection against infection throughout the entire manufacturing process.

Background: The aging population drives a growing demand for care, particularly in Europe. It is estimated that approximately 1.5–2 million individuals have a chronic wound. Among these, pressure ulcers (PUs) are one of the most prevalent complications in vulnerable individuals. Malnutrition is a primary risk factor, yet it can be mitigated through proper nutrition and adequate community support. The community nurse plays a crucial role in managing chronic conditions and nutrition through constant and professional monitoring. Aim: This article presents a comprehensive systematic review (SR) protocol to examine the role of community nursing of nutritional intervention of frail population with wound care. Methods: A SR will be conducted according to international standards and reported following the PRISMA Guidelines for SRs. The search will be conducted in PubMed/Medline, Scopus, Embase, and CINAHL, supplemented by grey literature sources. The methodological quality and risk of bias will be assessed using the Critical Appraisal Skills Programme (CASP) framework. The protocol has been registered in the Open Science Framework (OSF). Conclusions: It is anticipated that the findings of this SR will provide new evidence on the relationships between nutritional nursing interventions and wound care management primarily in the community setting.

Background/Objectives: Malignant hyperthermia (MH) is an uncommon but potentially fatal pharmacogenetic syndrome triggered by specific anesthetic agents, including certain muscle relaxants and volatile anesthetics. The clinical presentation of MH varies widely, making timely recognition challenging but essential to patient survival. Perioperative nurses have a critical role in MH prevention, crisis recognition, and effective management. This review aimed to identify and summarize current evidence on the perioperative nursing management of MH, emphasizing preventive measures, staff education, and the adoption of innovative strategies to enhance patient outcomes. Methods: A narrative literature review was conducted by searching the PubMed–Medline, Scopus, and Web of Science databases. The methodological quality was ensured using the Scale for the Assessment of Narrative Review Articles (SANRA), and the review process adhered to the PICOS framework. For transparency, the protocol has been reported to the Open Science Framework (OSF). Results: Nineteen studies met the inclusion criteria and were analyzed. The key findings underscored the vital role of perioperative nurses in conducting thorough preoperative risk assessments to identify susceptible individuals. Simulation-based training emerged as highly beneficial, improving staff preparedness, crisis recognition, teamwork, and communication skills. The integration of cognitive aids, such as emergency checklists, and the use of activated charcoal filters to rapidly reduce anesthetic gas concentrations were also highlighted as effective management strategies. Nonetheless, significant gaps in MH knowledge among nursing staff persist, indicating the need for ongoing education and training. Conclusions: Effective management of MH critically depends on comprehensive nurse-led assessments, regular simulation drills, and continuous staff education. The adoption of cognitive aids and activated charcoal filters further enhances crisis response capabilities. Future research should continue to explore innovative training methods and strategies to mitigate knowledge deficits among perioperative nursing teams.

Background and Objectives: Music therapy has a long tradition in palliative care, and recent studies have investigated its Neuro-Psycho-Endocrine-Immunological (NPEI) effects in terminally ill patients. Despite numerous published articles, there is a lack of a compendium connecting the physiological basis of music therapy with the specific musical elements most effective in end-of-life settings. This narrative review aims to synthesize current evidence on the physiological mechanisms underlying responses to music, with a focus on terminal patients and implications for nursing practice. Materials and Methods: For quality and possible reproducibility, a narrative review was conducted in accordance with Scale for the Assessment of Narrative Review Articles (SANRA) guidelines. The review targeted articles from the past five years indexed in PubMed, CINAHL, Cochrane Library, Embase, Scopus, Web of Science, and PsycInfo, supplemented by additional relevant references identified through manual searching. The PICOS framework was performed to structure the search strategy and study selection, focusing on studies relevant to the biological effects of music therapy in end-of-life care and their practical implications for nursing care. Results: The neurophysiology of music perception in terminal patients is complex, involving a wide array of clinical and cultural factors. Key musical elements—such as rhythm, melody, harmony, tempo, and mode—can influence physiological and psycho-emotional responses. Music therapy interventions, when tailored to the individual’s preferences and cultural background, may modulate parameters like heart rate, blood pressure, stress hormone levels, and pain perception. Evidence supports the need for individualized approaches and highlights the NPEI rationale for integrating music therapy into end-of-life care. Conclusions: A deeper understanding of the scientific mechanisms discussed in this narrative review can enhance the effectiveness of music therapy interventions in end-of-life settings. Nursing practice can benefit by integrating evidence-based selection of musical pieces and personalizing interventions to the clinical and cultural profile of each patient. Further interdisciplinary research is needed to establish standardized criteria for music therapy in palliative care and to optimize outcomes for terminally ill patients.