Clinical Research Directory

Non-Invasive Detection and Preservation of Neurocognitive Signals in the Peri-Death Period Using Brain-Computer Interface and Artificial Intelligence

Background: Recent electroencephalography (EEG) data indicate that the transition from clinical death to cellular death is marked by highly organized neurophysiological events, including significant surges in gamma-band power, cross-frequency coupling, and distinct spreading depolarization waves. This prospective, observational feasibility study utilizes rapid-deployment, high-density, noninvasive BCI hardware paired with proprietary AI analytics to detect, classify, and securely archive these terminal neurocognitive signals. Objectives: (1) Quantify transient gamma-band activity and cross-frequency connectivity post-clinical death; (2) Validate the efficacy of machine learning models for real-time signal classification in high-noise clinical environments; (3) Establish a highly secure, encrypted bio-informational archive of peri-life EEG data. Design: Prospective, open-label, multicenter, observational cohort (n\>20).

Death Anxiety, Depression and Anxiety: An Experimental Study

The goal of this experimental study is to investigate the transdiagnostic role of death anxiety in depression and anxiety symptoms in participants from the general population. The main questions it aims to answer are: 1. Does the mortality salience task induce death anxiety? 2. Does the experimental group present an increase in depression and anxiety symptoms following the mortality salience task? The investigators will compare the experimental condition to a control condition to see if the death anxiety induction is responsible for the expected increase in depression and anxiety symptoms. The mortality salience prompt will be asking participants to elaborate on their thoughts and feelings surrounding death and dying, including what they think happens during death. The dental pain prompt will ask participants to do the same, only in regards to the thought of having dental pain. Experimental group: participants will undergo a pen-and-paper writing task where they will be asked to answer two questions: 1. "Please briefly describe the emotions that the thought of your own death arouses in you." 2. "Jot down, as specifically as you can, what you think will happen to you physically as you die and once you are physically dead." Control group: 1. "Please briefly describe the emotions that the thought of dental pain arouses in you." 2. "Jot down, as specifically as you can, what you think happens to you physically as you experience dental pain and once you have physically experienced dental pain."

Analysis of COMPASsion and Humanisation of Adolescents Facing the End-of-life Processes.

The investigators want to work on compassion, understood as the recognition of the suffering of others that motivates us to try to alleviate it. The goal of this Multicenter project, with a mixed sequential transformative methodology, is to analyze the impact of a participatory process of awareness and reflection on compassion, in the face of end-of-life processes, in adolescents aged 12-23 years in 6 Spanish provinces, and to understand how the participatory process can transform and improve their compassion. As the adolescents must be the protagonists of change, the study will be conducted with students enrolled in one public secondary school and in one degree in a public University, that belongs to the same "health area" in each province. The investigators also include families' and teachers' knowledge of the context because it can support the interventions of change proposals. Compassion will be assessed using the Compassion for the Lives of Others Scale (COOLS), comprising 26 items. Similarly, adolescents' attitudes toward death are another important concept and will be explored through the Death Anxiety Scale (DAS), which has 15 questions. Both scales will be distributed to the adolescents, requesting their permission anonymously. After the survey, a second phase will start with a Participatory Action Research (PAR) with different activities. The objective is to generate awareness of the need to improve it, allowing the participants to design the interventions, based on evidence-based proposals (cinema forum, colloquiums with testimonies of volunteers accompanying palliative patients, organization of Death Cafe, artistic and literary activities, generation of grief groups, etc.). At the end of the project, the investigators will evaluate the adolescent compassion level and create discussion groups again to understand the impact of the interventions. With this project, the investigators will empower new generations of people to encourage, facilitate, support, and celebrate mutual care and family and community development in end-of-life processes. The translation and implications of the results for clinical practice will contribute to reducing inequalities in health research in a vulnerable group of special interest, especially when treatments can do nothing for their survival but with interventions such as those in this study, the investigators can ensure quality and dignity of life as long as there is life.

Effectiveness of an Online Religiously-integrated Cognitive Behavioral Therapy-based Intervention on Death Anxiety

There has been growing awareness of the importance of death anxiety (DA) in pathological anxiety. DA is defined as a persistent and unreasonable fear of death and thoughts, fears, and emotions associated with the end of life. DA has been suggested as a core fear that underpins the emergence and perseverance of numerous anxiety disorders. However, previous DA-based treatment studies focus on the elderly, the patients, or health professionals who care for the terminally ill. Therefore, there is a need to examine the effect of psychological interventions on DA and current disorder symptoms in a clinical sample through randomized controlled trials. The current study aims to develop a novel Religiously Integrated Cognitive Behavioral Therapy (RCBT)-based intervention on DA in individuals diagnosed with an anxiety disorder and to compare the effectiveness of RCBT-based intervention with classical CBT-based intervention.

The Effect of Situation Puzzle Games on Nursing Students' Death Anxiety and Meaning in Life

Goal of this interventional study The purpose of this research is to investigate the effects of a scenario-based puzzle educational game on death anxiety and meaning in life among nursing students. It aims to answer the following key questions: Can the scenario-based puzzle educational game enhance nursing students' sense of meaning in life? Can the scenario-based puzzle educational game reduce death anxiety in nursing students? What are nursing students' experiences and perceptions of this educational game? Study design Researchers will compare the intervention group (participating in the game) with a control group (receiving death education manuals) to evaluate the effectiveness of the game-based intervention. Participants will: Be recruited through campus posters Be randomly assigned to either the intervention or control group and complete baseline questionnaires In the control group: Receive death education manuals twice weekly for 3 weeks In the intervention group: Participate in group sessions (5 students per group) to play the scenario-based puzzle game twice weekly for 3 weeks Complete follow-up questionnaires and participate in qualitative interviews regarding their experiences with manual-based education or the game intervention after the 3-week intervention period

The Effect of Mindfulness-Based Death Psychoeducation Program on Death Awareness and Death Anxiety Levels in Nurses

Nurses are the primary caregivers for individuals who experience difficult situations (disease, loss, etc.) or are in the terminal phase. This may cause nurses to be exposed to the same experiences secondarily. Coming face to face with death can be a traumatic experience for individuals. Whether death is a traumatic experience for nurses may vary depending on individual differences and environmental conditions. Factors affecting nurses in this sense include the unit they work in, death anxiety, death awareness, workload, and sociodemographic characteristics. Studies conducted with nurses indicate that nurses' death anxiety varies depending on the unit and other factors, and that nurses need training for death awareness and the right approach to individuals. A study conducted on death education and grief counseling determined that individuals' participation in death education does not always help them cope with death and grief, but that individuals can be significantly helped in the face of death and loss if individual differences in coping with grief are focused on and helping skills are developed. It is thought that the awareness-based death-themed psychoeducation program to be applied to nurses in line with their educational needs will increase nurses' death awareness and reduce their death anxiety levels. The nurses working at Kastamonu Education and Research Hospital will constitute the universe of the study. The research will be conducted with nurses in a pre-test-post-test, experimental and control group experimental design. A power analysis will be conducted to determine the number of people to be included in the sample. It will be calculated with G\*Power 3.1 program. In the sample calculation, effect size (d=1.1), 5% margin of error (α=0.05) and power (1-β=0.95) were taken into account and 30 people were needed in the groups, 15 experimental and 15 control. However, considering the data loss, the sample size for each group was increased by 20% and it was planned to include 18 people in each group, a total of 36 people in the sample. In addition to descriptive statistical methods (Mean, Standard deviation) in the evaluation of the data, correlation test will be used to evaluate the relationship between the mean scores before and after the education in the comparison of quantitative data. Wilcoxon Associated Sample Test will be used to make comparisons before and after the education. ''Nurses Descriptive Information Form'', ''Multidimensional Death Awareness Scale'' and ''Thorson Powell Death Anxiety Scale'' will be used in the collection of data. A mindfulness-based psychoeducation program will be applied to the experimental group. The aim of the psychoeducation is to reduce the death anxiety of the nurses and to increase their awareness of death by providing them with information about the death experience they are secondarily exposed to (1- Death process and death anxiety, 2- Effects of the death process on the individual and family, 3- Coping with the death process, 4- Effects of the death process on caregiving nurses, 5- Awareness of death, 6- Nursing care and emotional competence during the death process). Therefore, it will be evaluated whether the applied psychoeducation program reduces the intended death anxiety and creates awareness about death. This study will be conducted to examine the effect of a 6-week, 12-session mindfulness-based group psychoeducation program given to nurses on death anxiety and death awareness levels.

From Fear to Purpose ACT Protocol. Implications of Death Anxiety in Depression and Anxiety Symptoms.

The main purpose of this placebo controlled trial is to test the efficacy of a one-session From Fear to Purpose ACT intervention in reducing self-reported death anxiety levels. Another objective of this study is to investigate whether reductions in death anxiety levels are associated with reductions in depression and anxiety levels, thus testing if death anxiety is a transdiagnostic factor involved in psychopathology.