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Enfermería Clínica is a peer-reviewed scientific journal that is a useful and necessary tool for nurses from the different areas of nursing (healthcare, administration, education and research) as well as for healthcare professionals involved in caring for persons, families and the community. It is the only Spanish nursing journal that mainly publishes original research. Its objectives are to promote the dissemination of knowledge, promote the development of evidence in care and contribute to the integration of research in clinical practice. These objective is pursued throughout the different sections that comprise the Journal: Original Articles and Short Original Articles, Reviews, Patient Care and Letters to the Editor. There is also an Evidence-Based Nursing section that includes two kinds of articles: comments about original articles of special interest written by experts, and evidence synthesis articles based on bibliographic reviews.

The journal is included in National Library of Medicine/Pubmed/Medline, Scopus/SCImago Journal Rank(SJR), Emerging Sources Citation Index (ESCI) (Clarivate Analytics), CINHAL, Elsevier Bibliographic Databases, EBSCO Publishing, Biblioteca Nacional de Ciencias de la Salud, CSIC/IME, IBECS, Latindex, CUIDEN, Dialnet, Google Scholar Metrics.

Types of article

Editorial. This section will consider comments and reflections on any new topic related to care or to health sciences in general, that may be of interest to Nursing professionals.

 Editorials will usually be commissioned by the editorial board, although the Journal is open to proposals on topics and authors that may be able to develop them.

Originals. Original research studies carried out using qualitative or quantitative methodology, or both, will be published in this section. Systematic reviews on any aspect related with care will also be considered for this section. The originals quantitative methodology must not exceded 3,000 words. The maximum number of literature references will not exceed 30, and there will be no more than 6 Tables or Figures. 

Their structure will be: Introduction, Method, Results, and Discussion. It will include an structured abstract (Objective, Method, Results, and Conclusions), in Spanish and in English, of a minimum of 250 words each one. 

The maximum number of authors allowed for these types of articles will be 6. 

Originals with Qualitative Methodology 

The original manuscripts with qualitative methodology will not be adapted to all the sections of the proposed structure, but they could take the following order: Introduction, Method, Results, and Discussion, and Conclusions. If the type and content of the study so requires it, the number of words of the body of the manuscript could be extended to 25,750 characters with spaces, and the number of references, up to 40.

The recommendations to follow for manuscripts that have used quantitative methodology must be taken into account in the Abstract and the Introduction. The rest of the sections must contain sufficient information on the development of the study. 

In the Method section it must give all the information necessary so that the readers may know how the study has been carried out. Thus, therefore it must explain the theoretical starting point, the design type followed must be described and justified. It must be explained how the participants have been selected, to mention the sample saturation, the contrasting of results with other participants / informants, the search for negative cases, mechanisms for ensuring information saturation, etc. It must described how the information collection techniques were used. 

The results and discussion must be based on the rigour of the em-pirical data collected. It must differentiate in the text where the results are obtained from the participants are mentioned and the opinion of the authors, which must be based on the information of the partici-pants. The most relevant data must be selected and identified with the initials of the groups or participants, for example, G1, G2, ACM, etc. The conclusions have to specify the response to the study question considered, indicating the contribution that it provides for the under-standing of the phenomenon studied and indicating the relevance for patients and nurses. 

Brief Originals. Research studies with the same characteristics as originals will be considered for this section, but on a smaller scale (series with a reduced number of observations, research studies with very specific aims and results), that may be published in a more abbreviated form. The maximum length of the text will be 9,400 characters with spaces, and up to 2 Tables and/or Figures will be allowed, and up to 10 literature references. The structure of these articles will be the same as Originals (Introduction, Method, Results, and Discussion),. with a structured Resumen/ Abstract (Objective, Method, Results, and Conclusions), in Spanish and in English, of 250 words each one.

Original articles and Short Originals include a section in which it summarises what is known on the topic and the new contributions of the study carried out. For this, it must include a text with two sub-sections that jointly must not exceed 500 characters (spaces included), with one paragraph indicating on the one hand “What is known” on the subject, and on the other hand “What it contributes”, in the study presented.

The maximum number of authors allowed for these types of articles will be 6.

Special articles. These types of articles may be on various topics, among which are highlighted: the approach to topics associated with research methodology, specialties, academic and professional development of Nursing or any other type of article in English or Spanish, of which the Editorial Team may consider its contents to be of great relevance for Nursing and in accordance with the currents trends at national and international level.

The Editorial Team is open to any suggestions by authors or inter-ested groups in which the knowledge of a specific or novel aspect of the profession is updated. Its length must not exceed 16,750 characters with spaces, and up to 30 references.

The maximum number of authors allowed will be 6.

Nursing Care. In this section, articles will be published that deal with the current state of knowledge on specific aspects, experiences or interventions of Nursing that may be of great interest, particularly based on the experience of the author or authors. Their topics could include, not only problems in the health care setting, but also matters on teaching, research or management content. Their structure will be: Introduction, Development, Discussion, Conclusions, and References. The maximum length will be 9,400 characters with spaces. It will include a Resumen/Abstract of 1,650 characters with spaces, in Span-ish and in English. Up to a maximum of 2 Tables and/or Figures will be allowed, and up to 10 literature references.

An impersonal text is recommended, with a clear division of the sections and with no more than a maximum of 4 authors.

Clinical Cases will also be included in this section, of basically descriptive works on one or several cases of exceptional interest, or due to their rare frequency, or for their unusual outcome or for their contribution to the knowledge of nursing practice in any of its aspects. This section allows clinical practice professionals to pass on their experiences in a systematic form, and that other professionals can understand them and discuss them, which without doubt contribute to bringing together the theory and the practice. Descriptions and/or evaluations of nursing interventional programs will be accepted.

Its length must not exceed 9,400 characters with spaces. It will include a Resumen/Abstract of 1,650 characters with spaces, in Span-ish and in English. Up to a maximum of 2 Tables and/or Figures will be allowed, and up to 10 literature references.

It is obvious that not all clinical cases can be faithfully adapted to the outline proposed here; however, by following these guidelines as far as possible will without any doubt contribute to a better presentation and understanding of the case: Title of the clinical case, Description of the case ( which will briefly include data collection, diagnostic tests performed and the clinical diagnosis, giving details on which health field the care was carried out), General Assessment (it is recommended to identify Nursing Diagnoses, Cooperation problems, according to NANDA taxonomy, using some form of systematic assessment: needs, functional patterns, etc.), Planning and Execution of the care (it is recommended to use expected Results and Interventions according to the NOC and NIC taxonomies), Evaluation of the Results / Follow-up and Discussion / implications for clinical practice.

Evidenced Based Nursing (EBN). Two types of articles are included in the section:

Literature review articles and update of knowledge in a specific field in the form of summaries of evidence (narrative reviews, integrators, scoping rewiew).

The structure will be: Introduction, Method, Results, Discussion and Recommendations, depending on the levels of evidence and the findings found, and Bibliography. The maximum extension will be 6,400 characters with spaces. It will include a structured summary of 1,650 characters with spaces, in Spanish and English, and 3 to 5 key words (using Mesh / DECS descriptors). Up to 2 tables and / or figures and 15 bibliographical references will be accepted.

The recommendations for this format are the following:

Introduction: Should be brief, following the indications of the journal, should include the objective that defines the problem to be investigated;

Methodology: Use of descriptors and search strategy (reproducible, delimited in the study period, inclusion and exclusion criteria), nature of the sources consulted, procedure for data extraction and methodological evaluation, if applicable;

Results: Responding to the objectives set, it must contain the description of the results found in the selection process of the articles, classification and synthesis of the studies found and their degrees of recommendation.

The following grades of recommendation are derived from the levels and degrees of evidence established by the Joanna Briggs Institute in 2014 (http://joannabriggs.org/jbi-approach.html#tabbed-nav=Grades-of-Recommendation): Grade A or strong; Grade B or weak for a specific care strategy;

Discussion and Recommendations: Following the usual structure of the journal, the authors should present their opinions and reflections derived from the findings, comparing them with the results obtained in other studies, with the corresponding bibliographic references. The possible limitations will also be indicated. The pertinent conclusions and recommendations will be reflected according to the degrees of recommendation found, as well as to the implications for the practice;

References: See section References format. It is recommended that the majority come from prestigious authors and publications, being recommended that at least 50% correspond to references of the last 50 years and 80% to references of the last 10 years.

Tables:a flow chart and summary table must be included with the selected articles.

Evidenced Based Nursing (EBN). Summaries of evidence in a comment articles format will be published in this section. In these types of articles, the comments must be made by experts on the subject and must be focused on applicability of the results obtained in practice and an analysis of the methodological rigour with the study has been performed. These articles will be considered extremely useful for readers and have as an objective to translate the scientific evidence into the health care setting, and to bring the most relevant studies in a national and international context closer to the professionals, providing tools that will enable the validity and relevance of their results to be estimated, as well as to evaluate if these may be useful to adapt to their clinical practice. 

Letters to the Editor. This section will publish scientific and formally accepted observations on published works. It is also a space so that readers may send their comments on current topics, on any aspect associated with the health sciences that may be of interest for professionals. It is the ideal section for the exchange of ideas and opinions between readers, authors and the Journal Editorial Team, in which we invite you to take part. It should also include the investigation results that, due to its reduced length, will not constitute an article for the Originals or Short Original sections. The maximum length will be 700 words, and 1 Table or Figure will be allowed, and a maximum of 5 literature references.

Contact details for submission

You can send your manuscript at https://www.editorialmanager.com/enfclin/default.aspx

Page charges

This journal has no page charges.


This journal is published in Spanish and in English language. Manuscripts can be sent in both languages. The journal will publish two versions, one in printed and online format and one only online translated entirely into English. The translation into English will not entail a cost for the authors.

Submission checklist

You can use this list to carry out a final check of your submission before you send it to the journal for review. Please check the relevant section in this Guide for Authors for more details.
Ensure that the following items are present:
One author has been designated as the corresponding author with contact details:

  • E-mail address
  • Full postal address

All necessary files have been uploaded:

  • Include keywords
  • All figures (include relevant captions)
  • All tables (including titles, description, footnotes)
  • Ensure all figure and table citations in the text match the files provided
  • Indicate clearly if color should be used for any figures in print

Graphical Abstracts / Highlights files (where applicable)
Supplemental files (where applicable)
Further considerations

  • Manuscript has been 'spell checked' and 'grammar checked'
  • All references mentioned in the Reference List are cited in the text, and vice versa

Permission has been obtained for use of copyrighted material from other sources (including the Internet)

  • A competing interests statement is provided, even if the authors have no competing interests to declare
  • Journal policies detailed in this guide have been reviewed
  • Referee suggestions and contact details provided, based on journal requirements

For further information, visit our Support Center.

Ethics in publishing

Please see our information pages on Ethics in publishing and Ethical guidelines for journal publication.

Studies in humans and animals

If the work involves the use of human subjects, the author should ensure that the work described has been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans. The manuscript should be in line with the Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals and aim for the inclusion of representative human populations (sex, age and ethnicity) as per those recommendations. The terms sex and gender should be used correctly.

Authors should include a statement in the manuscript that informed consent was obtained for experimentation with human subjects. The privacy rights of human subjects must always be observed.

All animal experiments should comply with the ARRIVE guidelines and should be carried out in accordance with the U.K. Animals (Scientific Procedures) Act, 1986 and associated guidelines, EU Directive 2010/63/EU for animal experiments, or the National Institutes of Health guide for the care and use of Laboratory animals (NIH Publications No. 8023, revised 1978) and the authors should clearly indicate in the manuscript that such guidelines have been followed. The sex of animals must be indicated, and where appropriate, the influence (or association) of sex on the results of the study.

Informed consent and patient details

Studies on patients or volunteers require ethics committee approval and informed consent, which should be documented in the paper. Appropriate consents, permissions and releases must be obtained where an author wishes to include case details or other personal information or images of patients and any other individuals in an Elsevier publication. Written consents must be retained by the author but copies should not be provided to the journal. Only if specifically requested by the journal in exceptional circumstances (for example if a legal issue arises) the author must provide copies of the consents or evidence that such consents have been obtained. For more information, please review the Elsevier Policy on the Use of Images or Personal Information of Patients or other Individuals. Unless you have written permission from the patient (or, where applicable, the next of kin), the personal details of any patient included in any part of the article and in any supplementary materials (including all illustrations and videos) must be removed before submission.

Submission declaration

Submission of an article implies that the work described has not been published previously (except in the form of an abstract or as part of a published lecture or academic thesis, see 'Multiple, redundant or concurrent publication' section of our ethics policy for more information), that it is not under consideration for publication elsewhere, that its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere including electronically in the same form, in English or in any other language, without the written consent of the copyright-holder.

Submission declaration and verification

Submission of an article implies that the work described has not been published previously (except in the form of an abstract or as part of a published lecture or academic thesis, see 'Multiple, redundant or concurrent publication' section of our ethics policy for more information), that it is not under consideration for publication elsewhere, that its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere in the same form, in English or in any other language, including electronically without the written consent of the copyright-holder. To verify originality, your article may be checked by the originality detection service Crossref Similarity Check.


Please note that preprints can be shared anywhere at any time, in line with Elsevier's sharing policy. Sharing your preprints e.g. on a preprint server will not count as prior publication (see 'Multiple, redundant or concurrent publication' for more information).

Use of inclusive language

Inclusive language acknowledges diversity, conveys respect to all people, is sensitive to differences, and promotes equal opportunities. Content should make no assumptions about the beliefs or commitments of any reader; contain nothing which might imply that one individual is superior to another on the grounds of age, gender, race, ethnicity, culture, sexual orientation, disability or health condition; and use inclusive language throughout. Authors should ensure that writing is free from stereotypes, slang, reference to dominant culture and/or cultural assumptions.  We advise to seek gender neutrality by using plural nouns ("clinicians, patients/clients") as default/wherever possible to avoid using "he, she," or "he/she." We recommend avoiding the use of descriptors that refer to personal attributes such as age, gender, race, ethnicity, culture, sexual orientation, disability or health condition unless they are relevant and valid. These guidelines are meant as a point of reference to help identify appropriate language but are by no means exhaustive or definitive.


All authors should have made substantial contributions to all of the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be submitted.

Changes to authorship

Authors are expected to consider carefully the list and order of authors before submitting their manuscript and provide the definitive list of authors at the time of the original submission. Any addition, deletion or rearrangement of author names in the authorship list should be made only before the manuscript has been accepted and only if approved by the journal Editor. To request such a change, the Editor must receive the following from the corresponding author: (a) the reason for the change in author list and (b) written confirmation (e-mail, letter) from all authors that they agree with the addition, removal or rearrangement. In the case of addition or removal of authors, this includes confirmation from the author being added or removed.
Only in exceptional circumstances will the Editor consider the addition, deletion or rearrangement of authors after the manuscript has been accepted. While the Editor considers the request, publication of the manuscript will be suspended. If the manuscript has already been published in an online issue, any requests approved by the Editor will result in a corrigendum.

Clinical trial results
In line with the position of the International Committee of Medical Journal Editors, the journal will not consider results posted in the same clinical trials registry in which primary registration resides to be prior publication if the results posted are presented in the form of a brief structured (less than 500 words) abstract or table. However, divulging results in other circumstances (e.g., investors' meetings) is discouraged and may jeopardise consideration of the manuscript. Authors should fully disclose all posting in registries of results of the same or closely related work.
Reporting clinical trials

Randomized controlled trials should be presented according to the CONSORT guidelines. At manuscript submission, authors must provide the CONSORT checklist accompanied by a flow diagram that illustrates the progress of patients through the trial, including recruitment, enrollment, randomization, withdrawal and completion, and a detailed description of the randomization procedure. The CONSORT checklist and template flow diagram are available online.

Registration of clinical trials
Registration in a public trials registry is a condition for publication of clinical trials in this journal in accordance with International Committee of Medical Journal Editors recommendations. Trials must register at or before the onset of patient enrolment. The clinical trial registration number should be included at the end of the abstract of the article. A clinical trial is defined as any research study that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects of health outcomes. Health-related interventions include any intervention used to modify a biomedical or health-related outcome (for example drugs, surgical procedures, devices, behavioural treatments, dietary interventions, and process-of-care changes). Health outcomes include any biomedical or health-related measures obtained in patients or participants, including pharmacokinetic measures and adverse events. Purely observational studies (those in which the assignment of the medical intervention is not at the discretion of the investigator) will not require registration.
Article transfer

This journal uses the Elsevier Article Transfer Service to find the best home for your manuscript. This means that if an editor feels your manuscript is more suitable for an alternative journal, you might be asked to consider transferring the manuscript to such a journal. The recommendation might be provided by a Journal Editor, a dedicated Scientific Managing Editor, a tool assisted recommendation, or a combination. If you agree, your manuscript will be transferred, though you will have the opportunity to make changes to the manuscript before the submission is complete. Please note that your manuscript will be independently reviewed by the new journal. More information.


Upon acceptance of an article, authors will be asked to complete a 'Journal Publishing Agreement' (see more information on this). An e-mail will be sent to the corresponding author confirming receipt of the manuscript together with a 'Journal Publishing Agreement' form or a link to the online version of this agreement.

Subscribers may reproduce tables of contents or prepare lists of articles including abstracts for internal circulation within their institutions. Permission of the Publisher is required for resale or distribution outside the institution and for all other derivative works, including compilations and translations. If excerpts from other copyrighted works are included, the author(s) must obtain written permission from the copyright owners and credit the source(s) in the article. Elsevier has preprinted forms for use by authors in these cases.

For open access articles: Upon acceptance of an article, authors will be asked to complete an 'License Agreement' (more information). Permitted third party reuse of open access articles is determined by the author's choice of user license.

Author rights
As an author you (or your employer or institution) have certain rights to reuse your work. More information.

Elsevier supports responsible sharing

Find out how you can share your research published in Elsevier journals.

Role of the funding source

You are requested to identify who provided financial support for the conduct of the research and/or preparation of the article and to briefly describe the role of the sponsor(s), if any, in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. If the funding source(s) had no such involvement then this should be stated.

Open Access

Please visit our Open Access page from the Journal Homepage for more information.

Elsevier Researcher Academy

Researcher Academy is a free e-learning platform designed to support early and mid-career researchers throughout their research journey. The "Learn" environment at Researcher Academy offers several interactive modules, webinars, downloadable guides and resources to guide you through the process of writing for research and going through peer review. Feel free to use these free resources to improve your submission and navigate the publication process with ease.

Language (usage and editing services)

Please write your text in good English (American or British usage is accepted, but not a mixture of these). Authors who feel their English language manuscript may require editing to eliminate possible grammatical or spelling errors and to conform to correct scientific English may wish to use the English Language Editing service available from Elsevier's Author Services.

Our online submission system guides you stepwise through the process of entering your article details and uploading your files. The system converts your article files to a single PDF file used in the peer-review process. Editable files (e.g., Word, LaTeX) are required to typeset your article for final publication. All correspondence, including notification of the Editor's decision and requests for revision, is sent by e-mail.
Submit your article

Please submit your article via https://www.editorialmanager.com/enfclin/default.aspx

The manuscripts will be separated into the following files, which will be entered into the system in the following order: 

First page: The following details should be indicated in the order given here: a) title of the article (in Spanish and in English); b) first name and the two surnames joined by a hyphen of each author (in order to identify you in the international data bases); c) institutional affiliation (full name of the department, and the centre where the work and its full address); d) name, professional affiliation, including e-mail address, and telephone of the author responsible for correspondence; e) total or partial funding of the study, if there is any; f) acknowledgements (this section must be used to acknowledge the help of individu-als or institutions who may have contributed to the development of the work, but could not be considered as authors. The study subjects should appear first in this section, since without their cooperation the study would not have been possible). 

At the end of this first page it will include the total number of char-acters with spaces of the abstract (in Spanish and in English), and of the body of the manuscript, (Introduction, Method, Results, and Dis-cussion). It will also indicate the number of characters with spaces of the paragraphs, “What is known” and “What it contributes”. 

What is known / What it contributes. Include the paragraphs on “What is known” and “What it contributes”. 

Text of the manuscript. It will include, in the following order: a) Abstract and key words, both in Spanish and in English; b) text or body of the manuscript, with the different sections depending on what it is about; c) literature references; d) Tables, if there are any. 

Figures. They must be included in a separate file. 


Title: It must briefly and concisely indicate the contents of the manu-script and it has to provide the maximum information with the minimum number of words (it recommended not to exceed 15). It must not include acronyms. A short title should be included with a maximum of 80 characters with spaces. 

Abstract and Keywords: For Original and Short Original works, it has to be structured into the following sections: Objective, Method, Results (most important 3-4) and Conclusion (1-2, arising from the results). It should contain sufficient information for the reader to have a clear idea of the contents of the manuscript. It should not contain information that cannot be found later in the manuscript. 

On the same page it will give between 3 and 6 keywords, directly related to the topic presented in the manuscript. MeSH terms (Medical Subject Headings) should be used or the Health Sciences Descriptors (Decs) so that they can be classified in the international data bases. 

A Spanish and English version of the abstract and keywords must be submitted. 

Text or body of the manuscript: It is advisable to divide the work clearly into sections, depending on the section to which it may be submitted: 

Originals and Short Originals: Introduction, Method, Results, and Discussion. 

Introduction: The introduction should include the definition of the basic concepts, contextualize the topic of study, justify its relevance and expose the current state of the topic. In the last part the objectives of the study will be defined. It will be as brief as possible, and its basic rule is to provide the basic information necessary for the reader to be able to understand the text that follows later. All of this supported with the most current and important literature references.

Method: An exhaustive description must be provided on how the study has been performed, with sufficient information so that other researchers can replicate it; that is, that they can perform it without consulting the authors. 

Its content will be determined by the objectives of the study. It will contain several sub-sections that do not need to be specified in the text: 

Design: The type of study performed must be mentioned, justifying, if necessary, the reasons for its choice. 

Population and Study Setting: Indicate the place and the date of performing the study. Specify the characteristics of the studied population and the inclusion and exclusion criteria. If all the population has not been studied, it must indicate how the sample size was calculated and the value of the parameters used, as well as the sampling technique.

Variables: Define all the variables that have been collected, determined by the objectives established, particularly the variables of the most important results. If it is an experimental study, it must mention the intervention made (also of the control group, if relevant and the follow-up time. 

Data collection: Explain how the data have been collected and who did it, as well as the tools used for this purpose, indicating if they are validated and the corresponding literature reference. 

Data Analysis: Mention the statistics program used for the analysis and the analysis performed. Indicate the strategy used for the literature review, that is, data bases reviewed, the descriptors or keywords employed in the search and the years reviewed. 

Ethical Aspects: It must be specified, in the case of research studies, whether it has been approved by the corresponding Ethics Committee, and whether it complies with the requirement estab-lished in national and international guidelines for clinical trials and similar studies as applicable. 

Results: It must only include the most important results, according to the objectives and the statistical analysis mentioned in the Method section. The results must respond exactly to the objectives that have been established and must make clear whether or not they certify the working hypothesis. There should not be any objective in the introduction that is not given a response in the results and any objective not mentioned in the introduction should not have a response in the results. Assessments or comments on the results obtained should also not be included in this section. 

In general, it should start with a description of the study subjects, to specifically know the number studied and their characteristics. If, subjects have been lost during the study, or it has not been able to contact, with the total of the sample selected, it must also indicate both the number and the reason. 

After the description of the subjects, a descriptive analysis of the most important variables will be presented, according to the measurement scale, and the most suitable manner to describe them will be chosen, attempting to provide the best information about each one (thus, frequencies and percentages will be used for the nominal qualitative variables, and for the quantitative ones, mean and standard deviation when they follow a normal distribution, etc.). The corresponding confidence intervals will also be indicated. 

If there is more than one study group, each one must be characterised, and later indicate the comparisons between these groups in terms of statistical significance an magnitude of the difference and, above all, in terms of clinical relevance. Statistical tests that have not been described in the Method section must not be employed, and their results must be accompanied by a statistical value, degrees of freedom and statistical significance (P value), and the confidence interval (where appropriate). To indicate the P value, it is advisable not to use more than 3 decimals (P=.002); thus, a value of P=.000001 may be expressed as P

Tables and/or Figures can be used to complement the information, not to duplicate it. The Tables and Figures must be sufficiently clear to be able to interpret them with the need to refer to the text. If abbrevia-tions or initials are used, they must be explained in the Table or Figure footnotes.

If there is more than one study group, each one should be characterized, and then indicate the comparisons between these groups in terms of statistical significance and magnitude of the difference and, above all, in terms of clinical relevance.

After describing the subjects, the descriptive analysis of the most important variables will be presented, according to the measurement scale, and the most appropriate way to describe them will be chosen, trying to provide the best information about each one (thus, for the qualitative variables nominal frequencies and percentages will be used, for the quantitative, mean and standard deviation when following a normal distribution, etc.). The corresponding confidence intervals will also be indicated.

Discussion: In this section, the authors must express their opinions on study topic and the results obtained, avoiding repetition of the information that has been given in the Results or in the Introduction. Comparison should be made with the results obtained in other studies, with the corresponding literature references. Mention should be made of the possible limitations of the study that could determine the interpretation of the results. The conclusions and the appropriate recom-mendations will be reflected, as well as suggestions for future studies on the topic and the implications that it has for the practice. The Discussion, as in the Conclusions, must arise directly from the results, and comments or statements that are not associated with the results obtained in the study must be avoided. It should also take into account, that although statistically significant differences are found in the hypothesis contrasts, these differences may not be relevant in clinical practice and, therefore, there should be caution when interpreting them.

In the discussion should include the limitations of the study and finalize the conclusions within this same section, without indicating a specific heading for it.

Bibliography: The adapting of the literature references to the Vancouver Style and their accuracy are the responsibility of the authors, therefore it is advised to make an exhaustive review of these and check them with the original documents, so that they do not contain errors that could hinder locating them by interested readers. The literature reference must be consecutively numbered using Arabic numbers in superscript according to their appearance in the text for the first time. When they coincide with a punctuation sign, the citation will always precede that sign. Examples on how to write literature reference can be consulted on the page: http://www.nlm.nih.gov/bsd/uniform_requirements.html.  

The bibliographical references should be numbered correlatively according to their appearance in the text for the first time, with Arabic numerals flown. When they match a punctuation mark, the quote will always precede that sign. 

It is recommended that the bibliographic references included should not be more than 10 years old, and that at least half of them be less than 5 years old, including references from prestigious journals

Tables and Figures: The Tables will be presented at the end of the manuscript, one on each page, with the title in their upper part and numbered with Arabic numerals, in the order that they appear in the text. The Figures must be submitted in a separate file, also with a title and numbered in order of appearance. The Figures and Tables must not repeat the results that have been mentioned in the text and must be clear; they should not have to refer to the text to be able to understand their content, thus, the title must be explanatory and must be accompanied by the necessary clarification footnotes.


Please submit the names and institutional e-mail addresses of several potential referees. For more details, visit our Support site. Note that the editor retains the sole right to decide whether or not the suggested reviewers are used.

Peer review

This journal operates a double blind review process. All contributions are typically sent to a minimum of two independent expert reviewers to assess the scientific quality of the paper. The Editor is responsible for the final decision regarding acceptance or rejection of articles. The Editor's decision is final. More information on types of peer review.

Double-blind review

This journal uses double-anonymized review, which means the identities of the authors are concealed from the reviewers, and vice versa. More information is available on our website. To facilitate this, please include the following separately:
Title page (with author details): This should include the title, authors' names affiliations, acknowledgements and any Declaration of Interest statement, and a complete address for the corresponding author including an e-mail address.
Anonymized manuscript (no author details): The main body of the paper (including the references, figures, tables and any acknowledgements) should not include any identifying information, such as the authors' names or affiliations.

Use of word processing software

It is important that the file be saved in the native format of the word processor used. The text should be in single-column format. Keep the layout of the text as simple as possible. Most formatting codes will be removed and replaced on processing the article. In particular, do not use the word processor's options to justify text or to hyphenate words. However, do use bold face, italics, subscripts, superscripts etc. When preparing tables, if you are using a table grid, use only one grid for each individual table and not a grid for each row. If no grid is used, use tabs, not spaces, to align columns. The electronic text should be prepared in a way very similar to that of conventional manuscripts (see also the Guide to Publishing with Elsevier). Note that source files of figures, tables and text graphics will be required whether or not you embed your figures in the text. See also the section on Electronic artwork.
To avoid unnecessary errors you are strongly advised to use the 'spell-check' and 'grammar-check' functions of your word processor.

Article structure
Subdivision - unnumbered sections

Divide your article into clearly defined sections. Each subsection is given a brief heading (Introduction, Method, Results and Discussion). Each heading should appear on its own separate line. Subsections should be used as much as possible when cross-referencing text: refer to the subsection by heading as opposed to simply 'the text'.


State the objectives of the work and provide an adequate background, avoiding a detailed literature survey or a summary of the results.


Provide sufficient detail to allow the work to be reproduced. Methods already published should be indicated by a reference: only relevant modifications should be described.


Results should be clear and concise.


This should explore the significance of the results of the work, not repeat them. A combined Results and Discussion section is often appropriate. Avoid extensive citations and discussion of published literature.


The main conclusions of the study may be presented in a short Conclusions section, which may stand alone or form a subsection of a Discussion or Results and Discussion section.


If there is more than one appendix, they should be identified as A, B, etc. Formulae and equations in appendices should be given separate numbering: Eq. (A.1), Eq. (A.2), etc.; in a subsequent appendix, Eq. (B.1) and so on. Similarly for tables and figures: Table A.1; Fig. A.1, etc.

Essential title page information

Title. Concise and informative. Titles are often used in information-retrieval systems. Avoid abbreviations and formulae where possible.
Author names and affiliations. Please clearly indicate the given name(s) and family name(s) of each author and check that all names are accurately spelled. You can add your name between parentheses in your own script behind the English transliteration.  Present the authors' affiliation addresses (where the actual work was done) below the names. Indicate all affiliations with a lower-case superscript letter immediately after the author's name and in front of the appropriate address. Provide the full postal address of each affiliation, including the country name and, if available, the e-mail address of each author.
Corresponding author. Clearly indicate who will handle correspondence at all stages of refereeing and publication, also post-publication. This responsibility includes answering any future queries about Methodology and Materials. Ensure that the e-mail address is given and that contact details are kept up to date by the corresponding author.
Present/permanent address. If an author has moved since the work described in the article was done, or was visiting at the time, a 'Present address' (or 'Permanent address') may be indicated as a footnote to that author's name. The address at which the author actually did the work must be retained as the main, affiliation address. Superscript Arabic numerals are used for such footnotes.


Highlights are optional yet highly encouraged for this journal, as they increase the discoverability of your article via search engines. They consist of a short collection of bullet points that capture the novel results of your research as well as new methods that were used during the study (if any). Please have a look at the examples here: example Highlights.

Highlights should be submitted in a separate editable file in the online submission system. Please use 'Highlights' in the file name and include 3 to 5 bullet points (maximum 85 characters, including spaces, per bullet point).

Structured abstract

A structured abstract, by means of appropriate headings, should provide the context or background for the research and should state its purpose, basic procedures (selection of study subjects or laboratory animals, observational and analytical methods), main findings (giving specific effect sizes and their statistical significance, if possible), and principal conclusions. It should emphasize new and important aspects of the study or observations.

The headings will consist of: «Objective», «Method», «Results» and «Conclusions».

Graphical abstract

Although a graphical abstract is optional, its use is encouraged as it draws more attention to the online article. The graphical abstract should summarize the contents of the article in a concise, pictorial form designed to capture the attention of a wide readership. Graphical abstracts should be submitted as a separate file in the online submission system. Image size: Please provide an image with a minimum of 531 × 1328 pixels (h × w) or proportionally more. The image should be readable at a size of 5 × 13 cm using a regular screen resolution of 96 dpi. Preferred file types: TIFF, EPS, PDF or MS Office files. You can view Example Graphical Abstracts on our information site.
Authors can make use of Elsevier's Illustration and Enhancement service to ensure the best presentation of their images and in accordance with all technical requirements: Illustration Service.


Immediately after the abstract, provide a maximum of 6 keywords, using British spelling and avoiding general and plural terms and multiple concepts (avoid, for example, 'and', 'of'). Be sparing with abbreviations: only abbreviations firmly established in the field may be eligible. These keywords will be used for indexing purposes.

Define abbreviations that are not standard in this field in a footnote to be placed on the first page of the article. Such abbreviations that are unavoidable in the abstract must be defined at their first mention there, as well as in the footnote. Ensure consistency of abbreviations throughout the article.
Collate acknowledgements in a separate section at the end of the article before the references and do not, therefore, include them on the title page, as a footnote to the title or otherwise. List here those individuals who provided help during the research (e.g., providing language help, writing assistance or proof reading the article, etc.).
Formatting of funding sources

List funding sources in this standard way to facilitate compliance to funder's requirements:

Funding: This work was supported by the National Institutes of Health [grant numbers xxxx, yyyy]; the Bill & Melinda Gates Foundation, Seattle, WA [grant number zzzz]; and the United States Institutes of Peace [grant number aaaa].

It is not necessary to include detailed descriptions on the program or type of grants and awards. When funding is from a block grant or other resources available to a university, college, or other research institution, submit the name of the institute or organization that provided the funding.

If no funding has been provided for the research, please include the following sentence:

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Follow internationally accepted rules and conventions: use the international system of units (SI). If other units are mentioned, please give their equivalent in SI.
Image manipulation

Whilst it is accepted that authors sometimes need to manipulate images for clarity, manipulation for purposes of deception or fraud will be seen as scientific ethical abuse and will be dealt with accordingly. For graphical images, this journal is applying the following policy: no specific feature within an image may be enhanced, obscured, moved, removed, or introduced. Adjustments of brightness, contrast, or color balance are acceptable if and as long as they do not obscure or eliminate any information present in the original. Nonlinear adjustments (e.g. changes to gamma settings) must be disclosed in the figure legend.

Electronic artwork

General points
• Make sure you use uniform lettering and sizing of your original artwork.
• Embed the used fonts if the application provides that option.
• Aim to use the following fonts in your illustrations: Arial, Courier, Times New Roman, Symbol, or use fonts that look similar.
• Number the illustrations according to their sequence in the text.
• Use a logical naming convention for your artwork files.
• Provide captions to illustrations separately.
• Size the illustrations close to the desired dimensions of the published version.
• Submit each illustration as a separate file.
• Ensure that color images are accessible to all, including those with impaired color vision.

A detailed guide on electronic artwork is available.
You are urged to visit this site; some excerpts from the detailed information are given here.

If your electronic artwork is created in a Microsoft Office application (Word, PowerPoint, Excel) then please supply 'as is' in the native document format.
Regardless of the application used other than Microsoft Office, when your electronic artwork is finalized, please 'Save as' or convert the images to one of the following formats (note the resolution requirements for line drawings, halftones, and line/halftone combinations given below):
EPS (or PDF): Vector drawings, embed all used fonts.
TIFF (or JPEG): Color or grayscale photographs (halftones), keep to a minimum of 300 dpi.
TIFF (or JPEG): Bitmapped (pure black & white pixels) line drawings, keep to a minimum of 1000 dpi.
TIFF (or JPEG): Combinations bitmapped line/half-tone (color or grayscale), keep to a minimum of 500 dpi.
Please do not:
• Supply files that are optimized for screen use (e.g., GIF, BMP, PICT, WPG); these typically have a low number of pixels and limited set of colors;
• Supply files that are too low in resolution;
• Submit graphics that are disproportionately large for the content.

Color artwork

Please make sure that artwork files are in an acceptable format (TIFF (or JPEG), EPS (or PDF) or MS Office files) and with the correct resolution. If, together with your accepted article, you submit usable color figures then Elsevier will ensure, at no additional charge, that these figures will appear in color online (e.g., ScienceDirect and other sites). Further information on the preparation of electronic artwork.

Illustration services

Elsevier's Autor Services offers Illustration Services to authors preparing to submit a manuscript but concerned about the quality of the images accompanying their article. Elsevier's expert illustrators can produce scientific, technical and medical-style images, as well as a full range of charts, tables and graphs. Image 'polishing' is also available, where our illustrators take your image(s) and improve them to a professional standard. Please visit the website to find out more.

Figure captions

Ensure that each illustration has a caption. Supply captions separately, not attached to the figure. A caption should comprise a brief title (not on the figure itself) and a description of the illustration. Keep text in the illustrations themselves to a minimum but explain all symbols and abbreviations used.


Please submit tables as editable text and not as images. Tables can be placed either next to the relevant text in the article, or on separate page(s) at the end. Number tables consecutively in accordance with their appearance in the text and place any table notes below the table body. Be sparing in the use of tables and ensure that the data presented in them do not duplicate results described elsewhere in the article. Please avoid using vertical rules and shading in table cells.

Citation in text

Please ensure that every reference cited in the text is also present in the reference list (and vice versa). Any references cited in the abstract must be given in full. Unpublished results and personal communications are not recommended in the reference list, but may be mentioned in the text. If these references are included in the reference list they should follow the standard reference style of the journal and should include a substitution of the publication date with either 'Unpublished results' or 'Personal communication'. Citation of a reference as 'in press' implies that the item has been accepted for publication.

Reference links

Increased discoverability of research and high quality peer review are ensured by online links to the sources cited. In order to allow us to create links to abstracting and indexing services, such as Scopus, CrossRef and PubMed, please ensure that data provided in the references are correct. Please note that incorrect surnames, journal/book titles, publication year and pagination may prevent link creation. When copying references, please be careful as they may already contain errors. Use of the DOI is highly encouraged.

A DOI is guaranteed never to change, so you can use it as a permanent link to any electronic article. An example of a citation using DOI for an article not yet in an issue is: VanDecar J.C., Russo R.M., James D.E., Ambeh W.B., Franke M. (2003). Aseismic continuation of the Lesser Antilles slab beneath northeastern Venezuela. Journal of Geophysical Research, https://doi.org/10.1029/2001JB000884. Please note the format of such citations should be in the same style as all other references in the paper.

Web references

As a minimum, the full URL should be given and the date when the reference was last accessed. Any further information, if known (DOI, author names, dates, reference to a source publication, etc.), should also be given. Web references can be listed separately (e.g., after the reference list) under a different heading if desired, or can be included in the reference list.

Data references

This journal encourages you to cite underlying or relevant datasets in your manuscript by citing them in your text and including a data reference in your Reference List. Data references should include the following elements: author name(s), dataset title, data repository, version (where available), year, and global persistent identifier. Add [dataset] immediately before the reference so we can properly identify it as a data reference. This identifier will not appear in your published article.

References in a special issue

Please ensure that the words 'this issue' are added to any references in the list (and any citations in the text) to other articles in the same Special Issue.

Reference management software

Most Elsevier journals have their reference template available in many of the most popular reference management software products. These include all products that support Citation Style Language styles, such as Mendeley. Using citation plug-ins from these products, authors only need to select the appropriate journal template when preparing their article, after which citations and bibliographies will be automatically formatted in the journal's style. If no template is yet available for this journal, please follow the format of the sample references and citations as shown in this Guide. If you use reference management software, please ensure that you remove all field codes before submitting the electronic manuscript. More information on how to remove field codes from different reference management software.

Reference style

Text: Indicate references by superscript numbers in the text. The actual authors can be referred to, but the reference number(s) must always be given.
List: Number the references in the list in the order in which they appear in the text.
Reference to a journal publication:
1. Van der Geer J, Hanraads JAJ, Lupton RA. The art of writing a scientific article. J Sci Commun 2010;163:51–9. https://doi.org/10.1016/j.Sc.2010.00372.
Reference to a journal publication with an article number:
2. Van der Geer J, Hanraads JAJ, Lupton RA. The art of writing a scientific article. Heliyon. 2018;19:e00205. doi:10.1016/j.heliyon.2018.e00205.
Reference to a book:
3. Strunk Jr W, White EB. The elements of style. 4th ed. New York: Longman; 2000.
Reference to a chapter in an edited book:
4. Mettam GR, Adams LB. How to prepare an electronic version of your article. In: Jones BS, Smith RZ, editors. Introduction to the electronic age, New York: E-Publishing Inc; 2009, p. 281–304.
Reference to a website:
5. Cancer Research UK. Cancer statistics reports for the UK, http://www.cancerresearchuk.org/aboutcancer/statistics/cancerstatsreport/; 2003 [accessed 13 March 2003].
Reference to a dataset:
[dataset] 6. Oguro M, Imahiro S, Saito S, Nakashizuka T. Mortality data for Japanese oak wilt disease and surrounding forest compositions, Mendeley Data, v1; 2015. https://doi.org/10.17632/xwj98nb39r.1.
Note shortened form for last page number. e.g., 51–9, and that for more than 6 authors the first 6 should be listed followed by 'et al.' For further details you are referred to 'Uniform Requirements for Manuscripts submitted to Biomedical Journals' (J Am Med Assoc 1997;277:927–34)(see also Samples of Formatted References).

Journal abbreviations source

Journal names should be abbreviated according to the List of Title Word Abbreviations.


Elsevier accepts video material and animation sequences to support and enhance your scientific research. Authors who have video or animation files that they wish to submit with their article are strongly encouraged to include links to these within the body of the article. This can be done in the same way as a figure or table by referring to the video or animation content and noting in the body text where it should be placed. All submitted files should be properly labeled so that they directly relate to the video file's content. In order to ensure that your video or animation material is directly usable, please provide the file in one of our recommended file formats with a preferred maximum size of 150 MB per file, 1 GB in total. Video and animation files supplied will be published online in the electronic version of your article in Elsevier Web products, including ScienceDirect. Please supply 'stills' with your files: you can choose any frame from the video or animation or make a separate image. These will be used instead of standard icons and will personalize the link to your video data. For more detailed instructions please visit our video instruction pages. Note: since video and animation cannot be embedded in the print version of the journal, please provide text for both the electronic and the print version for the portions of the article that refer to this content.

Supplementary material

Supplementary material such as applications, images and sound clips, can be published with your article to enhance it. Submitted supplementary items are published exactly as they are received (Excel or PowerPoint files will appear as such online). Please submit your material together with the article and supply a concise, descriptive caption for each supplementary file. If you wish to make changes to supplementary material during any stage of the process, please make sure to provide an updated file. Do not annotate any corrections on a previous version. Please switch off the 'Track Changes' option in Microsoft Office files as these will appear in the published version.


This journal encourages and enables you to share data that supports your research publication where appropriate, and enables you to interlink the data with your published articles.  Research data refers to the results of observations or experimentation that validate research findings. To facilitate reproducibility and data reuse, this journal also encourages you to share your software, code, models, algorithms, protocols, methods and other useful materials related to the project.

Below are a number of ways in which you can associate data with your article or make a statement about the availability of your data when submitting your manuscript. If you are sharing data in one of these ways, you are encouraged to cite the data in your manuscript and reference list. Please refer to the "References" section for more information about data citation. For more information on depositing, sharing and using research data and other relevant research materials, visit the research data page.

Data in Brief

You have the option of converting any or all parts of your supplementary or additional raw data into one or multiple data articles, a new kind of article that houses and describes your data. Data articles ensure that your data is actively reviewed, curated, formatted, indexed, given a DOI and publicly available to all upon publication. You are encouraged to submit your article for <IT>Data in Brief</IT> as an additional item directly alongside the revised version of your manuscript. If your research article is accepted, your data article will automatically be transferred over to <IT>Data in Brief</IT> where it will be editorially reviewed and published in the open access data journal, <IT>Data in Brief</IT>.  Please note an open access fee is payable for publication in <IT>Data in Brief</IT>. Full details can be found on the <URL><HREF> http://www.journals.elsevier.com/data-in-brief</HREF><HTXT>Data in Brief website</HTXT></URL>. Please use <URL><HREF>http://www.elsevier.com/dib-template</HREF>this template<HTXT></HTXT></URL> to write your Data in Brief.


One set of page proofs (as PDF files) will be sent by e-mail to the corresponding author (if we do not have an e-mail address then paper proofs will be sent by post) or a link will be provided in the e-mail so that authors can download the files themselves. To ensure a fast publication process of the article, we kindly ask authors to provide us with their proof corrections within two days. Elsevier now provides authors with PDF proofs which can be annotated; for this you will need to download the free Adobe Reader, version 9 (or higher). Instructions on how to annotate PDF files will accompany the proofs (also given online). The exact system requirements are given at the Adobe site.
If you do not wish to use the PDF annotations function, you may list the corrections (including replies to the Query Form) and return them to Elsevier in an e-mail. Please list your corrections quoting line number. If, for any reason, this is not possible, then mark the corrections and any other comments (including replies to the Query Form) on a printout of your proof and scan the pages and return via e-mail. Please use this proof only for checking the typesetting, editing, completeness and correctness of the text, tables and figures. Significant changes to the article as accepted for publication will only be considered at this stage with permission from the Editor. We will do everything possible to get your article published quickly and accurately. It is important to ensure that all corrections are sent back to us in one communication: please check carefully before replying, as inclusion of any subsequent corrections cannot be guaranteed. Proofreading is solely your responsibility.


The corresponding author will, at no cost, receive a customized Share Link providing 50 days free access to the final published version of the article on ScienceDirect. The Share Link can be used for sharing the article via any communication channel, including email and social media. For an extra charge, paper offprints can be ordered via the offprint order form which is sent once the article is accepted for publication. Both corresponding and co-authors may order offprints at any time via Elsevier's Author Services. Corresponding authors who have published their article open access do not receive a Share Link as their final published version of the article is available open access on ScienceDirect and can be shared through the article DOI link.


Visit the Elsevier Support Center to find the answers you need. Here you will find everything from Frequently Asked Questions to ways to get in touch.
You can also check the status of your submitted article or find out when your accepted article will be published.

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos