Margarida Reis Santos

Background: Discrete choice experiments (DCEs) are quantitative preference-elicitation methods, developed largely within health economics, in which participants choose repeatedly between hypothetical scenarios composed of systematically varied attributes. Their growing use with children supports children’s right to be heard in decisions affecting their care, yet it also raises ethical challenges that general paediatric research ethics guidance does not address in operational detail: sustained cognitive demand, potential emotional distress, assent that can blur under clinical stress, parental influence, clinician–researcher role conflict, and the processing of children’s personal data. Methods: We developed a prospective ethical governance framework during the preparatory phase of the PREF-ANX Kids study (Preferences for Preoperative Anxiety Management in Children), a planned multicentre DCE examining preferences for nursing interventions to manage preoperative anxiety among children aged 6–12 years undergoing elective surgery in Portuguese public hospitals, their parents, and healthcare professionals. Development combined a pragmatic, non-systematic synthesis of ethical, regulatory, and methodological guidance with iterative structured discussion within an interdisciplinary team. No formal consensus method was applied, and no children or families were involved in development; we identify this as a limitation. Framework: The framework comprises four domains operating across the research lifecycle: relational participation, cognitive and emotional safeguarding, reflexive professional responsibility, and privacy stewardship. For each domain it specifies planned procedures (continuous assent and dissent monitoring, adapted task burden, structured reflexive documentation, and a prospective data protection impact assessment) together with their normative justification, and it distinguishes elements specific to PREF-ANX Kids from elements potentially adaptable to other paediatric DCEs. Trade-offs between competing ethical and methodological priorities are made explicit rather than resolved silently. Conclusions: The framework is prospective: it has not yet been implemented or empirically evaluated, and no claims of demonstrated effectiveness are made. It is intended to support transparent ethical planning of DCEs involving children aged 6–12 years and will be assessed during the PREF-ANX Kids study. Future refinement should incorporate co-design with children and families and empirical evaluation of feasibility, acceptability, participant experience, and data quality.

Introduction: Every year, millions of children and adolescents undergo surgery, 50%-75% of them experience fear and anxiety. Children are particularly susceptible to stress and anxiety surrounding surgery as a result of their cognitive development, previous experiences, and knowledge about healthcare; this leads to additional interventions to prevent and reduce these symptoms. Objective: To evaluate the effectiveness of family-centered educational interventions in the children’s and adolescents’ anxiety, pain, and behaviors and their parents’ anxiety during the perioperative period. Methods: This review will follow the Joanna Briggs Institute guidelines for systematic reviews of effectiveness and will consider those studies (experimental and quasi-experimental) in which perioperative educational interventions have been applied to children and adolescents and their parents; these studies measured children and adolescents’ pain, anxiety, and behaviors, as well as their parent’s anxiety. An initial search of MEDLINE and CINAHL will be followed by a second search for published and unpublished studies from January 2007 on, available in English, Spanish and Portuguese. After all full texts are retrieved, the methodological quality assessment and data extraction will be independently and critically evaluated by two reviewers, and the data will then be presented in a tabular format. An explanatory synthesis will accompany the results. Whenever possible, a meta-analysis will be performed, and a Grading of Recommendations, Assessment, Development, and Evaluation Summary of Findings will be presented. Expected Results: This review will provide guidance on how family-centred educational interventions can be used as a resource to manage anxiety, pain, and behavior in children, adolescents and their relatives during the perioperative processes.

Background The parent-infant relationship plays a central role in early emotional, cognitive, and social development. Difficulties in bonding, interaction, attachment, or parental sensitivity during the first two years of life may have lasting consequences for children and families, making early identification essential for timely support and intervention. Although a range of instruments has been developed to assess parent-infant relational processes, the evidence remains dispersed, and no comprehensive mapping of instruments specifically applicable from birth to 24 months has been identified. This scoping review aims to map the instruments used to assess parent-infant relationships during the first 24 months of life and to describe their main characteristics. Methods This scoping review protocol follows the Joanna Briggs Institute methodology for scoping reviews. Studies describing instruments used to assess the parent-infant relationship among parents of typically developing infants aged 0–24 months will be considered across any clinical, community, research, or cultural context. Eligible instruments may assess bonding, interaction, attachment, parental sensitivity, or related relational dimensions. Studies involving preterm infants, infants with medical conditions or developmental disorders, or instruments focused exclusively on parental stress or mental health without explicit assessment of relational dynamics will be excluded. A three-step search strategy will be used to identify published and unpublished studies and grey literature. Two reviewers will independently screen records, extract data using a piloted charting form, and summarise findings in tables and descriptive narrative form. The final scoping review will be reported in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR). This review will provide an overview of available instruments, their characteristics, contexts of use, psychometric properties, adaptations, and short-form versions. This protocol is registered in the Open Science Framework (DOI: 10.17605/OSF.IO/HRVX9).

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare the benefits and harms of pharmacological and non-pharmacological preoperative interventions (alone or in combination) for reducing anxiety in school-age children undergoing elective surgery under general anaesthesia, and to rank the interventions according to their efficacy and safety.

Early relational health during the first 24 months of life is a key determinant of child development and wellbeing. During this postnatal period, the parent–infant relationship plays a central role in emotional regulation, bonding, and developmental trajectories. Although the broader early relational health framework encompasses the first 1,000 days of life, this scoping review focuses specifically on the postnatal phase, where parent–infant interactions are directly observable and measurable. However, existing assessment instruments vary widely in their conceptual focus, scope, and characteristics, and no comprehensive review has systematically mapped tools used to assess the parent–infant relationship during early infancy. In response to this gap, a transdisciplinary working group within the COST Action CA22114 – TREASURE collaboratively developed a scoping review protocol to systematically map instruments assessing the parent–infant relationship from birth to 24 months of age. This Brief Report describes the collaborative methodological process underpinning the protocol’s development. The process followed an iterative, consensus-driven approach involving multidisciplinary experts from multiple COST member countries. Through structured online meetings, the group clarified core constructs and established the age range using the Population–Concept–Context (PCC) framework. The JBI methodology for scoping reviews was adopted and aligned with PRISMA-ScR standards to ensure transparency and reproducibility. Progressive drafting, internal peer review, and iterative refinement led to the final protocol, which was registered on the Open Science Framework (DOI: 10.17605/OSF.IO/HRVX9).The resulting protocol provides a replicable methodological framework for mapping instruments that assess the parent–infant relationship in the first two years of life. This Brief Report presents a framework for collaborative protocol development in international research networks, promoting shared knowledge generation in early relational health research and offering potential applicability to other COST initiatives.

Early relational health during the first 24 months of life is a key determinant of child development and wellbeing. The parent–infant relationship plays a central role in emotional regulation, bonding, and developmental trajectories. However, existing assessment tools differ widely in their scope and characteristics, and no comprehensive review has yet mapped the instruments available to assess this relationship in early infancy. In response to this gap, a transdisciplinary working group within the COST Action CA22114 – TREASURE collaboratively developed a scoping review protocol to systematically map instruments assessing the parent–infant relationship from birth to 24 months of age. This Brief Report outlines the collaborative methodological process used to construct the protocol. Development followed an iterative, consensus-driven approach involving multidisciplinary experts from multiple COST member countries. Through structured online meetings, the group clarified core constructs and established the age range using the Population–Concept–Context (PCC) framework. The JBI methodology for scoping reviews was adopted and aligned with PRISMA-ScR standards to ensure transparency and reproducibility. Progressive drafting, internal peer review, and iterative refinement led to the final protocol, which was registered on the Open Science Framework (DOI: 10.17605/OSF.IO/HRVX9). The resulting protocol provides a replicable methodological framework for mapping instruments that assess the parent–infant relationship. This Brief Report presents a framework for collaborative protocol development in international research networks, promoting shared knowledge generation in early relational health research and offering potential applicability to other COST initiatives.

The objective of this scoping review is to map the competencies required of clinical supervisors of nursing students. A scoping review will be conducted following Joanna Briggs Institute guidelines and the PRISMA-ScR checklist. We will search PubMed, CINAHL, PsycINFO, Scopus, and Web of Science, as well as grey literature sources, covering from 1993 through July 2025 without language restrictions. Inclusion criteria comprise studies involving clinical supervisors of undergraduate and postgraduate nursing students (Participants), explicitly defining the knowledge, skills, and attitudes that constitute effective supervision (Concept) in clinical education settings, such as hospital wards, community health settings, and simulation laboratories (Context). Two independent reviewers will screen titles/abstracts and full texts using Rayyan, with disagreements resolved by a third reviewer. Data charting will employ a piloted extraction form. The results of the search will be presented in a PRISMA-ScR flow diagram. Findings will be reported via narrative synthesis and tabular summaries detailing author/year, study aim, methodological design, competency definitions (knowledge, skills, attitudes), application contexts, and key conclusions. This comprehensive competency mapping is expected to inform educational practice, guide future research and underscore the importance of clinical supervision in nursing student training, curriculum development, and professional development.