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This paper focuses on integrating multimodal communication into the English-as-a-foreign-language classroom to enhance the development of students' multimodal communicative competence, multiliteracies, and 21st-century skills. To do so, I compiled a corpus of authentic materials from Lady Whistledown's Society Papers in Julia Quinn's novel "The Viscount Who Loved Me" (2000), her appearances as narrator in the Netflix series "Bridgerton" (2022), and some tweets posted by @Bridgerton. This corpus was used to plan and design a game-based teaching proposal. Finally, the paper offers a critical analysis and suggests how this proposal can feasibly contribute to fostering students' multimodal communicative competence.

Schools are ideal settings to promote adolescent physical activity (PA), yet school-based interventions have shown limited long-term impact. This position paper presents key issues surrounding school-based PA interventions. Collaborative conceptual thinking drawing on multi-author expertise and available evidence advanced our understanding and opinion. Key arguments: 1) the adoption of a systems approach, which maximizes partnership action and leverages policy, is crucial for understanding the complexities of implementing whole-school programs; 2) a reorientation to an assets perspective optimizes existing strengths and resources allowing greater emphasis on the full range of physical, cognitive, emotional and social benefits that PA provides, and 3) a move beyond traditional positivist research designs to advance our knowledge of what works better, for whom and in what context is needed for greater progress We provide suggestions, specifically advocating for systems approaches, as a realistic way to improve how we support PA in schools in the future.

The World Health Organization (WHO) officially declared the novel coronavirus (COVID-19) as a pandemic on 11 March 2020, and educational institutions have had to modify most of their activities (face-to-face activities were suspended). This situation forced academic institutions to modify the evaluation format of students. The use of proctoring systems quickly became widespread, although some controversies arose. The two main discussions regarding these systems are the integrity of the assessment and the capacity of the students to adapt to this new assessment method, without changes in theirs scores. To elucidate two controversies, we have analyzed the preferences and the scores obtained from a trial of 660 scores from 332 students of the third grade of Veterinary Medicine. The experiment involved three modalities of exam: an online format from home using the Respondus Lockdown Browser system (Modality 1), online in person using the Respondus Lockdown Browser system with the supervision of a teacher (Modality 2), or paper format in person with the supervision of a teacher (Modality 3). The results obtained showed that the students preferred Modality 1 (online at home with Respondus Lockdown Browser system). No statistical differences between the scores obtained by students were found between the three modalities analyzed. The proctoring system is a good method to adjudicate exams in higher education institutions, and the scores of students are similar to those obtained through traditional evaluation and control systems.

It is unknown whether and to what extent cognitive individual differences may play different roles in paper versus computer-based second language (L2) writing. This exploratory study is a first attempt to explore this issue, focusing on the effects of working memory and language aptitude on the quality of paper versus computer-based L2 writing performance. Forty-two Spanish learners of L2 English performed a problem-solving task either digitally or on paper, took a working memory n-back test, and completed LLAMA tests to measure language aptitude. The quality of their L2 written texts was assessed in terms of complexity, accuracy and fluency (CAF) measures. The results indicated that the role of cognitive individual differences may vary depending on the writing environment.

This study compared the effects of computer-mediated (CM) versus pen-and-paper (P&P) writing on written accuracy and feedback processing in tasks written and rewritten collaboratively following a pedagogical treatment in two intact authentic classrooms. The study involved 32 secondary education low-proficiency English-as-a-foreign-language (EFL) learners writing two descriptive texts collaboratively and receiving in-class training in the identification and correction of grammatical, lexical, and mechanical errors. Participants were provided with unfocused direct error correction (EC). Error logs were used to facilitate noticing of teacher corrections (i.e., feedback processing). Dyads were required to rewrite their texts for evidence of feedback uptake. Results indicate that writing collaboratively on the computer with the availability of the Internet contributes to increased grammatical and lexical accuracy. No differences were found between writing environments regarding feedback processing or accuracy of rewritten texts.

Introduction: Advancements in monoclonal antibodies, tyrosine kinase inhibitors, and antibody drug conjugates (ADCs) have notably enhanced outcomes for metastatic HER2-positive breast cancer patients. Despite the expanding treatment options and clinical complexities, determining the optimal sequence of HER2-targeted therapies remains partly uncertain, influenced by various factors., Methods: To refine HER2-positive metastatic breast cancer management, particularly regarding tucatinib's position, a Steering Committee of leading oncologists in breast cancer care devised a panel of statements via a Delphi approach, focusing on five key topics: general clinical management, therapeutic approaches for patients with HER2-positive breast cancer and brain metastases, treatment sequence, and tucatinib's safety and efficacy., Results: A total of 29 statements were deliberated, with strong consensus achieved for most. However, no consensus emerged regarding the management of brain progression alongside stable extracranial disease: 48 % advocated for switching to tucatinib, while 53 % favored a stereotactic brain radiotherapy (SBRT) approach if feasible., Conclusion: The unanimous consensus attained in this Delphi panel, particularly regarding tucatinib's efficacy and safety, underscores oncologists' recognition of its clinical significance based on existing trial data. These findings align closely with current literature, shedding light on areas necessitating further investigation, not thoroughly explored in prior studies. Moreover, the results underscore the scarcity of data on managing brain progression alongside stable extracranial disease, emphasizing the imperative for dedicated research to address these gaps and yield definitive insights., Competing Interests: Declaration of competing interest PC: Consulting or Advisory Role: Daiichi Sankyo/Lilly, Reveal Genomics, Gilead Sciences; Speakers' Bureau: Roche/Genentech, Novartis, AstraZeneca, Lilly, BMS; Research Funding: Merck KGaA (Inst); Patents, Royalties, Other Intellectual Property: HER2Dx patent; Expert Testimony: AstraZeneca. EC: reports consulting fees from Novartis, Lilly, Pfizer, Roche, AstraZeneca, and Daiichi Sankyo; speaker's bureau from Lilly, Pfizer, AstraZeneca, and Daiichi Sankyo; and travel and accommodations from Pfizer and Roche. GC: received honoraria for speaker's engagement: Roche, Seattle Genetics, Novartis, Lilly, Pfizer, Foundation Medicine, NanoString, Samsung, Celltrion, BMS, MSD; Honoraria for providing consultancy: Roche, Seattle Genetics, NanoString; Honoraria for participating in Advisory Board: Roche, Lilly, Pfizer, Foundation Medi-cine, Samsung, Celltrion, Mylan; Honoraria for writing engagement: Novartis, BMS; Honoraria for participation in Ellipsis Scientific Affairs Group; Institutional research funding for conducting phase I and II clinical trials: Pfizer, Roche, Novartis, Sanofi, Celgene, Servier, Orion, AstraZeneca, Seattle Genetics, AbbVie, Tesaro, BMS, Merck Serono, Merck Sharp Dome, Janssen-Cilag, Philogen, Bayer, Medivation, MedI- mmune MDL: advisory boards, activities as a speaker, travel grants, consultancy: Eli Lilly, Novartis, Seagen, Takeda, Roche, Daiichi Sankyo, Tomalab, Gilead, Genetic, Menarini, Sophos, AstraZeneca, Pfizer, Sanofi, Ipsen, Pierre Fabre, GSK. AG: research funding to the Institution: AstraZeneca, Pfizer, Janssen, Roche, MSD, Daichii-Sankyo, GSK/Tesaro, HiFiBio, Merck, Boehringer-Ingelheim, Exelixis, Bayer, Incyte, Bayer, Aileron; travel, accommodation, expenses: Gentili. LDM: advisory role for Agendia, Amgen, AstraZeneca, Collage SpA, Daiichi Sankyo, Eli Lilly, Exact Sciences, Gilead, GSK, Havas Life, Pfizer, Pierre Fabre, Roche, Seagen Int, Stemline Menarini and Uvet; personal fees as an invited speaker for Accademia Nazionale Medicina, Andromeda E20, Aristea, Delphi international, Editree, Eli Lilly, Ipsen, Meeting SrL, MSD, Novartis, Over Srl, Prex Srl, Symposia and Vyvamed Srl; personal fees for writing engagements for Edizioni Minerva Medica, Pensiero Scientifico Editore and Roche; personal consultancy fees from Eli Lilly, Gilead, Kardo Srl and Sharing Progress in Cancer Care (SPCC)—Switzerland; personal fees for author slide kits from Forum service and Think2it; personal fees for interviews from Infomedica Srl and Think2it; institutional funding as a local PI from AstraZeneca, Daiichi Sankyo, Eli Lilly, Gilead, Novartis, Novella Clinical, Roche and Seagen; institutional funding as a national coordinating PI from Roche; institutional research grant from Pfizer; and non-remunerated product samples from FoundationOne. AG: received advisory role from AstraZeneca, Daiichi, Eisai, Lilly, Novartis, Pfizer, Roche, Seagen, Gilead, Teva, and Gentili; lecture honoraria from Novartis, Pfizer, Gilead, Roche, Eisai, Seagen, Teva, and Gentili; and research support from Roche, Eisai, Gilead, and Pharmanutra AL: Research support: Roche, Agendia, Lilly, Pfizer, Novartis, Merck Sharp&Dhome, Gilead, Daiichi Sankyo; Consulting/advisor: Lilly, Roche, Pfizer, Novartis; Speaker's Bureaus: Lilly, Astrazeneca, Merck Sharp&Dhome, Pfizer, Novartis; Travel support: Roche, Pfizer, Astrazeneca, Merck Sharp&Dhome. MM: Honoraria: Roche/Genentech, Lilly, Pfizer, Novartis, Pierre Fabre, Seagen; Consulting or Advisory Role: Roche/Genentech, Novartis, Pfizer, Lilly, AstraZeneca, Daiichi-Sankyo; Speakers' Bureau: Lilly/ImClone, Lilly/ImClone, Roche/Genentech, Pierre Fabre; Research Funding: Novartis (Inst), Roche (Inst), Puma Biotechnology (Inst); Travel, Accommodations, Expenses: Daiichi-Sankyo; Other Relationship: Roche, Novartis. FPo: advisory board from AstraZeneca; speaking honoraria and travel grants from Eli Lilly, Novartis, Seagen, Daichii Sankyo, and Gilead. AP: reports grants and personal fees from NanoString Technologies, Veracyte, Novartis, AstraZeneca, DaiichiSankyo, and Roche; in addition, A. Prat has a patent for DNADX pending. FPu: reports honoraria for advisory boards, activities as a speaker, travel grants, research grants from Amgen - Astrazeneca - Daiichi Sankyo - Celgene - Eisai - Eli Lilly- Exact Sciences- Gilead - Ipsen – Menarini- MSD - Novartis - Pierre Fabre - Pfizer - Roche - Seagen - Takeda – Viatris; Research funding from Astrazeneca – Eisai – Roche. CS: consultancy or advisory role for AstraZeneca, Ax's Consulting, Byondis, Daiichi Sankyo, Eisai, Exact Sciences, Exeter, F. Hoffmann-La Roche Ltd., International Society for the Study and Exchange of evidence from Clinical research And Medical experience (ISSECAM), Medical Statistics Consulting, MediTech, Merck Sharp and Dohme Corp, Novartis, Pfizer, Philips, Pierre Fabre, PintPharma, Puma, Roche, Sanofi, Seagen, Zymeworks, and research funding from Aragon, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Byondis, CytomX, Daiichi Sankyo, F. Hoffmann-La Roche Ltd., Genentech, German Breast Group Forchungs, GlaxoSmithKline, Immunomedics, Innoup, International Breast Cancer Study Group (IBCSG), Lilly, Macrogenics, Medica Scientia Innovation Research, Menarini Ricerche, Merck Sharp and Dohme Corp, Merus, Millennium, Novartis, Pfizer, Piqur, Puma, Roche, Sanofi, Seagen, Synthon, and Zenith., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Meningococcal meningitis (MM) and invasive meningococcal disease remain a major public health problem that generates enormous public alarm. It is caused by Neisseria meningitidis, a Gram-negative diplococcus with an enormous capacity for acute and rapidly progressive disease, both episodic and epidemic in nature, with early diagnosis and treatment playing a major role. It occurs at any age, but is most common in children under 5 years of age followed by adolescents. Although most cases occur in healthy people, the incidence is higher in certain risk groups. Despite advances in reducing the incidence, it is estimated that in 2017 there were around 5 million new cases of MM worldwide, causing approximately 290,000 deaths and a cumulative loss of about 20,000,000 years of healthy life. In Spain, in the 2021/22 season, 108 microbiologically confirmed cases of MM were reported, corresponding to an incidence rate of 0.23 cases per 100,000 inhabitants. This is a curable and, above all, vaccine-preventable disease, for which the World Health Organisation has drawn up a roadmap with the aim of reducing mortality and sequelae by 2030. For all these reasons, the Illustrious Official College of Physicians of Madrid (ICOMEM) and the Medical Associations of 8 other provinces of Spain, have prepared this opinion document on the situation of MM in Spain and the resources and preparation for the fight against it in our country. The COVID-19 and Emerging Pathogens Committee of ICOMEM has invited experts in the field to participate in the elaboration of this document., (©The Author 2024. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

The apps for drawing are present in our children's life. Nevertheless, little is known about the impact of mobile technology on the freehand drawing educational activity. There are few works which are contextualised within short periods of time, with teachers who are not theirs and, in some cases, outside the children's classroom. In this paper, we are focussed on the use of technology on freehand drawing activity. Thus, we have compared the graphics produced by 4- and 5-year-old children with paper&crayon in comparison with those with tablet-finger. Children made the drawings during a planned free-drawing activity, in their ordinary classrooms, with their teachers and during five sessions. Assessment of drawings has evidenced tablet feasibility for making graphics. Nevertheless, with the passing of time, quality of graphics (tablet-finger vs paper&crayons), are nearly matched, demonstrating the low impact level technology has on this activity. In addition, if drawings are analysed specifically according to ages, results have shown that both groups have to develop adaptation strategies of visual perceptual skills and fine motor skills for the touch screen in order to obtain the same quality in the drawings made on both support types. [ABSTRACT FROM AUTHOR]

Summary: COVID-19 continues to pose a significant threat: mortality stands at nearly twice that of influenza, and the incidence rate is growing as the population's vaccination rate decreases, particularly in Spain and other areas of Europe. Given this situation, it is vitally important know whether medical protocols are consistent and appropriately implemented by health care staff in the interest of preventing possible inefficiency or inequity. Physicians from hospital emergency departments met to study their hospitals' usual clinical practices for managing SARS-CoV-2 infection and to determine their expert opinions on the use of antiviral agents. The participating physicians then reached consensus on evidencebased recommendations for strategies that would optimize emergency treatment.

Chicken meat is well known for its high nutritional value. Its shelf life is short, due to the pronounced perishability, even under refrigeration. Paper bags are usually used as packaging materials, due to their biodegradability. The main negative aspect concerning paper is its high porosity and low moisture barrier. In this regard, it has to be coated/modified with efficient moisture barrier materials. The storage of chicken breast meat wrapped in four types of paper‐based materials currently in use in Romania (RO), Italy (IT), Spain (SP) and Slovenia (SLO) is reported. RO and IT are paper coated with polyethylene (PE) film, SP is waxed paper, and SLO is paper modified with hydrophobized starch. The influence of the coating film on the organoleptical, biochemical and microbiological characteristics of the chicken breast meat stored at 4°C was the aim of the study. The mathematical modelling revealed two aspects: (1) the stability period in which the meat safe for consumption is in the range 1.92–2.18 days in the case of all paper types, and (2) cadaverine, the amine generated by protein degradation, is a less sensitive indicator of the meat alteration than microbial growth. The papers coated with PE (RO and IT samples) and with hydrophobized starch (SLO paper) were packaging materials more efficient that the waxed paper (SP sample). The polyethylene film reduced the conversion of putrescine into spermidine in a higher extent than wax. [ABSTRACT FROM AUTHOR]

Bisphenol A (BPA) is a high-production-volume chemical with endocrine disrupting properties commonly used as color developer in thermal paper. Concerns about the potential hazards of human BPA exposure have led to the increasing utilization of alternatives such as bisphenol S (BPS) and bisphenol F (BPF). This study was designed to assess: (i) BPA, BPS, and BPF concentrations in 112 thermal paper receipts from Brazil, France, and Spain by liquid chromatography coupled to mass spectrometry (LC-MS); and (ii) hormone-like activities of these receipts using two receptor-specific bioassays, the E-Screen for (anti-)estrogenicity and PALM luciferase assay for (anti-)androgenicity. BPA was present in 95.3% of receipts from Spain, 90.9% of those from Brazil, and 51.1% of those from France at concentrations up to 20.27 mg/g of paper. Only two samples from Brazil, two from Spain, and ten from France had a BPS concentration ranging from 6.46 to 13.29 mg/g; no BPA or BPS was detected in 27.7% of French samples. No BPF was detected in any receipt. Estrogenic activity was observed in all samples from Brazil and Spain and in 74.5% of those from France. Anti-androgenic activity was observed in > 90% of samples from Brazil and Spain and in 53.2% of those from France. Only 25.5% of French samples were negative for both estrogenic and anti-androgenic activity. Estrogenic and anti-androgenic activities per gram of paper were up to 1.411 µM estradiol (E 2 ) equivalent units (E 2 eq) and up to 359.5 mM procymidone equivalent units (Proceq), respectively. BPA but not BPS concentrations were positively correlated with both estrogenic and anti-androgenic activities. BPA still dominates the thermal paper market in Brazil and Spain, and BPS appears to be one of the main alternatives in France. There is an urgent need to evaluate the safety of alternatives proposed to replace BPA as developer in thermal printing. The large proportion of samples with hormonal activity calls for the adoption of preventive measures., (Copyright © 2018 Elsevier Inc. All rights reserved.)

This document is the result of the deliberations of the Committee on Emerging Pathogens and COVID-19 of the Illustrious Official College of Physicians of Madrid (ICOMEM) regarding the current situation of tuberculosis, particularly in Spain. We have reviewed aspects such as the evolution of its incidence, the populations currently most exposed and the health care circuits for the care of these patients in Spain. We have also discussed latent tuberculosis, the reality of extrapulmonary disease in the XXI century and the means available in daily practice for the diagnosis of both latent and active forms. The contribution of molecular biology, which has changed the perspective of this disease, was another topic of discussion. The paper tries to put into perspective both the classical drugs and their resistance figures and the availability and indications of the new ones. In addition, the reality of direct observation in the administration of antituberculosis drugs has been discussed. All this revolution is making it possible to shorten the treatment time for tuberculosis, a subject that has also been reviewed. If everything is done well, the risk of relapse of tuberculosis is small but it exists. On the other hand, many special situations have been discussed in this paper, such as tuberculosis in pediatric age and tuberculosis as a cause for concern in surgery and intensive care. The status of the BCG vaccine and its present indications as well as the future of new vaccines to achieve the old dream of eradicating this disease have been discussed. Finally, the ethical and medicolegal implications of this disease are not a minor issue and our situation in this regard has been reviewed., (©The Author 2023. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

In 1786 the Basque thinker and military man Manuel de Aguirre entered a competition for ideas on how to improve national legislation in order to achieve public happiness. His proposal consisted in drawing up the draft of the first Spanish constitution. It was a very basic project, but it showed how part of the Spanish Enlightenment was interested in reforming the Enlightenment despotism of Charles III and replacing it with a representative government, in which the king still had important powers, though these were limited by bodies of a representative nature. [ABSTRACT FROM AUTHOR]

Amongst the various translations from Hebrew into Spanish produced in medieval Spain, those of Mishnaic tractates are inspiring scholarly interest in recent decades. The present article is concerned with some aspects of these texts. Particularly interesting are the questions of attitudes to them; their cultural/ intellectual significance and function; what they tell us about languages in the late medieval Iberian Peninsula. Finally, the article presents an edition of a previously unknown MS of such a translation from the Cairo Geniza. [ABSTRACT FROM AUTHOR]

Featured Application: Papermaking industry and technology. Innovative applications of vegetal residues. This study examines the potential of four invasive plant species, both arboreal and herbaceous, within the riparian forest of the Umia River in Galicia, a common ecosystem in northern Spain. These invasive species (Arundo donax, Phytolacca americana, Eucalyptus globulus, and Tradescantia fluminensis) were collected and assessed for their suitability as an alternative source of pulp and paper materials for the paper industry to mitigate the environmental impacts associated with conventional cellulose fiber production from harmful monocultures. Cellulosic material from leaves, bark, and/or stems of each of the selected species was isolated from lignin and hemicelluloses through kraft pulping processes. Resulted fibers and pulps were analyzed visually, morphologically, chemically, and mechanically to evaluate their papermaking properties. To compare these properties with those of commercially available pulp, test sheets were concurrently produced using commercial bleached Eucalyptus cellulose. The findings reveal that the employed fibers exhibit promising characteristics for artistic paper production. Regarding the pulp, two refining times were tested in a PFI machine, and the Schopper–Riegler degree was measured. Paper sheets underwent various tests to determine thickness, basis weight, apparent volume, apparent density, permeability, and chemical composition, as well as microscopic optical and morphological properties. The fibers obtained from the waste derived from the removal of invasive exotic species and biodiversity control present a viable and intriguing alternative for decentralized paper production, yielding noteworthy results for the creative sector. This research highlights the potential of harnessing invasive species for sustainable and innovative paper manufacturing practices. [ABSTRACT FROM AUTHOR]

During the coronavirus pandemic, changes in the way science is done and shared occurred, which motivates meta‐research to help understand science communication in crises and improve its effectiveness. The objective is to study how many Spanish scientific papers on COVID‐19 published during 2020 share their research data. Qualitative and descriptive study applying nine attributes: (a) availability, (b) accessibility, (c) format, (d) licensing, (e) linkage, (f) funding, (g) editorial policy, (h) content, and (i) statistics. We analyzed 1,340 papers, 1,173 (87.5%) did not have research data. A total of 12.5% share their research data of which 2.1% share their data in repositories, 5% share their data through a simple request, 0.2% do not have permission to share their data, and 5.2% share their data as supplementary material. There is a small percentage that shares their research data; however, it demonstrates the researchers' poor knowledge on how to properly share their research data and their lack of knowledge on what is research data. [ABSTRACT FROM AUTHOR]

Although, Spain does not obtain an official arctic strategy, it was mentioned in the paper for Spanish Polar Strategy that the Arctic region has become one of the country's national interests. The government of Spain is also deeply concerned about the problem of climate change and how it affects economic and social aspects of life. When addressing the Arctic energy issue we must make a prior delimitation, since it does not propose to study in detail, and only in general description, the internal functioning of the Arctic energy systems, that is, the one that serves to supply their populations with lighting, water, gas or electricity. [ABSTRACT FROM AUTHOR]

This paper analyses the quality of information collected by a self-administered survey responded to by a general population, who were offered the possibility of answering using the post or Internet. The analysis will be focused on the use of three grid questions with using rating scales with 6, 6 and 8 items, respectively. There was a polar point labelled scale (0-10) with verbal labels only at the endpoints. The postal survey showed greater acquiescence, a greater choice of extreme response categories and 'easy' answers, and a greater number of incomplete questions.

Background: In recent years, significant advances have been made in the field of rare diseases (RDs). However, there is a large number of RDs without specific treatment and half of these treatments have public funding in Spain. The aim of the FINEERR project was to carry out a multidisciplinary strategic discussion on the challenge of funding and access to RD-targeted drugs in Spain, in order to agree on specific proposals for medium-term improvement and hence support decision-making in the Spanish National Healthcare System (SNHS)., Results: The FINEERR Project was organized around a CORE Advisory Committee, which provided an overview, agreed on the design and scope of the project, and selected the members within each of four working groups (WG). Overall, 40 experts discussed and reached a consensus on different relevant aspects, such as conditioning factors for initial funding and access, evaluation and access to RD-targeted therapies, funding of these therapies, and implementation of a new funding and access model. From these meetings, 50 proposals were defined and classified by their level of relevance according to the experts. A descriptive analysis of responses was performed for each proposal. Thereafter, experts completed another questionnaire where they ranked the 25 most relevant proposals according to their level of feasibility of being implemented in the SNHS. The most relevant and feasible proposals were to improve: process of referral of patients with RDs, control over monitoring mechanisms, and communication between healthcare professionals and patients., Conclusions: The FINEERR project may provide a starting point for stakeholders involved in the process of funding and access to RD-targeted therapies in Spain to provide the necessary resources and implement measures to improve both the quality of life and life expectancy of patients with RDs., (© 2023. The Author(s).)

We do not know the precise figure for solid organ tumors diagnosed each year in Spain and it is therefore difficult to calculate whether there has been a decrease in cancer diagnoses as a consequence of the pandemic. Some indirect data suggest that the pandemic has worsened the stage at which some non-hematological neoplasms are diagnosed. Despite the lack of robust evidence, oncology patients seem more likely to have a poor outcome when they contract COVID-19. The antibody response to infection in cancer patients will be fundamentally conditioned by the type of neoplasia present, the treatment received and the time of its administration. In patients with hematological malignancies, the incidence of infection is probably similar or lower than in the general population, due to the better protective measures adopted by the patients and their environment. The severity and mortality of COVID-19 in patients with hematologic malignancies is clearly higher than the general population. Since the immune response to vaccination in hematologic patients is generally worse than in comparable populations, alternative methods of prevention must be established in these patients, as well as actions for earlier diagnosis and treatment. Campaigns for the early diagnosis of malignant neoplasms must be urgently resumed, post-COVID manifestations should be monitored, collaboration with patient associations is indisputable and it is urgent to draw the right conclusions to improve our preparedness to fight against possible future catastrophes., (©The Author 2022. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

SARS-CoV-2 pandemic has changed across the last two years. The development and approval of SARS-CoV-2 vaccines and the emergence of new variants has opened up a new scenario. On this regard, Spanish Society of Nephrology (S.E.N.) Council considers that an update of the previous recommendations should be performed. In the present statement, and taking into account the current epidemiological situation, are included updated recommendations of protection and isolation for patients on dialysis programs., (Copyright © 2022 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

Allergy to Polistes dominula (European paper wasp) venom is of particular relevance in Southern Europe, potentially becoming a threat in other regions in the near future, and can be effectively cured by venom immunotherapy (VIT). As allergen content in extracts may vary and have an impact on diagnostic and therapeutic approaches, the aim was to compare five therapeutic preparations for VIT of P. dominula venom allergy available in Spain. Products from five different suppliers were analyzed by SDS-PAGE and LC-MS/MS and compared with a reference venom sample. Three products with P. dominula venom and one product with a venom mixture of American Polistes species showed a comparable band pattern in SDS-PAGE as the reference sample and the bands of the major allergens phospholipase A1 and antigen 5 were assignable. The other product, which consists of a mixture of American Polistes species, exhibited the typical band pattern in one, but not in another sample from a second batch. All annotated P. dominula allergens were detected at comparable levels in LC-MS/MS analysis of products containing P. dominula venom. Due to a lack of genomic information on the American Polistes species, the remaining products were not analyzed by this method. The major Polistes allergens were present in comparable amounts in the majority, but not in all investigated samples of venom preparations for VIT of P. dominula venom allergy. [ABSTRACT FROM AUTHOR]

(1) Background: The main basis for the public recognition of the merits of scientists has always been the system of scientific publications and citations. Our goal is to identify and analyze the most cited articles in the Public, Environmental & Occupational Health category. (2) Methods: We searched the Web of Science for all articles published in the "Public, Environmental & Occupational Health" category up to March 2022 and selected the 100 most cited articles. We recorded the number of citations, the journal, the year of publication, quartile, impact factor, institution, country, authors, topic, type of publication and collaborations. (3) Results: 926,665 documents were analyzed. The top 100 had 401,620 citations. The journal with the most articles was the Journal of Clinical Epidemiology and the one with the highest number of citations was Medical Care. The year with the highest number of articles in the top 100 was 1998. The country with the highest percentage of publications was the USA and the most productive institution was Harvard. The most frequent keywords were bias, quality, and extension. The largest collaboration node was between the USA, Canada, Germany, Spain, Australia, France, and Sweden. (4) Conclusions: This bibliometric study on Public, Environmental & Occupational Health provides valuable information not only to identify topics of interest in the analyzed category, but also to identify the differences in the topics they study.

Abstract Question In people who have undergone surgical carpal tunnel release, do sensorimotor-based exercises performed on the touchscreen of a tablet device improve outcomes more than a conventional home exercise program prescribed on paper? Design Randomised, parallel-group trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Participants Fifty participants within 10 days of surgical carpal tunnel release. Intervention Each participant was prescribed a 4-week home exercise program. Participants in the experimental group received the ReHand tablet application, which administered and monitored exercises via the touchscreen. The control group was prescribed a home exercise program on paper, as is usual practice in the public hospital system. Outcome measures The primary outcome was functional ability of the hand, reported using the shortened form of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Secondary outcomes were grip strength, pain intensity measured on a 10-cm visual analogue scale, and dexterity measured with the Nine-Hole Peg Test. Outcomes were measured by a blinded assessor at baseline and at the end of the 4-week intervention period. Results At Week 4, functional ability improved significantly more in the experimental group than the control group (MD –21, 95% CI –33 to –9) on the QuickDASH score (0 to 100). Although the mean estimates of effect on the secondary outcome also all favoured the experimental group, none reached statistical significance: grip strength (MD 5.6 kg, 95% CI –0.5 to 11.7), pain (MD –1.4 cm, 95% CI –2.9 to 0.1), and dexterity (MD –1.3 seconds, 95% CI –3.7 to 1.1). Conclusion Use of the ReHand tablet application for early rehabilitation after carpal tunnel release is more effective in the recovery of functional ability than a conventional home exercise program. It remains unclear whether there are any benefits in grip strength, pain or dexterity. Trial registration ACTRN12618001887268. [ABSTRACT FROM AUTHOR]

The eighteenth century books from the collection of the old digital library of the Library University Seville are analyzed to locate the parts made with decorated papers, in order to classify and describe them according to the proposals of specialized literature. For this, the records included in the repository of the digital collection are recovered, the digital reproductions of the books are visualized, the parts with decorated papers are identified and described following the decorated papers classification model, previously elaborated, based on the research of Professor Carpallo Bautista. The model is made up of 6 techniques and their variants. Of the more than 6.700 records from the 18th century in the collection of the digital ancient collection, 511 include decorated papers in their bindings. [ABSTRACT FROM AUTHOR]

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Objective: The aim of this study was to explore the geographic distribution and number of papers published in international and Science Citation Index (SCI)-indexed cytology journals based on their country of origin., Materials and Methods: A country-based geographic analysis of studies published over a 5.5-year period from January 2016 to June 2021 in 5 cytopathology journals indexed as SCI and SCI-E with an impact factor higher than 1 (Cancer Cytopathology, Cytopathology, Diagnostic Cytopathology, Acta Cytologica, and CytoJournal) and papers categorized as "original" and "other" was performed., Results: A total of 3,063 papers were found, with 1,466 (47.8%) categorized as "original" papers and 1,597 (52.1%) designated as "other" papers. These papers were submitted from 62 different countries. The five countries with the greatest number of papers were the USA (38.4%), India (16.8%), Japan (7.4%), Italy (5.5%), and Brazil (3.1%). A general subgroup analysis was also performed on the original studies without a country breakdown. Cytomorphological, cytomorphological-immunohistochemical, and molecular assessments compose 38.5%, 45.7%, and 15% of the subgroups, respectively., Conclusion: The number of academic papers originating from developing countries in the field of cytopathology has increased in recent years. Although most scientific papers are produced in developed countries, the rate in these countries is much lower than that in some developing countries as the rate of academic growth in developed countries has stabilized. Despite the widespread and sophisticated implementation of cytology in daily practice in Western European countries outside the UK, such as Germany and the Netherlands, and in Scandinavian countries and other developed countries, such as Australia and Canada, these countries rank in the middle to lower end of countries producing cytology papers. Meanwhile, there has been an increase in the number of cytology papers published by authors from Southern European countries, such as Italy (ranked 4th) and Spain (ranked 6th), and Turkey (ranked 8th). There is a remarkable increase in cytology papers originating from Asia, particularly India, Japan, and China., Summary: We aimed to present a basic survey of the geographic distribution of manuscript submissions to high-impact cytopathology journals and to point out emerging trends in cytology utilization and basic research. However, our results show that the landscape of cytology is changing and suggest geographic regions that are ripe for the production of novel "points of view" and new research findings., (© 2022 S. Karger AG, Basel.)

CAR-T cell therapy represents a therapeutic revolution in the prognosis and treatment of patients with certain types of hematological cancer. However, they also pose new challenges in the healthcare, regulatory and financial fields. The aim of the RET-A project was to undertake a strategic reflection on the management of CAR-T therapies within the Spanish National Health System, to agree on recommendations that will help to better deal with the new context introduced by these cell therapies in the present and in the future. This think tank involved 40 key agents and opinion leaders. The experts identified three great challenges for implementing advanced therapies in Spain: therapeutic individualisation, with a multidisciplinary approach; acceleration of access times, by minimizing bureaucracy; and increase in the number of centers qualified to manage the CAR-T therapies in the NHS. The experts agreed on the ideal criteria for designating those qualified centers. They also agreed on a comprehensive CAR-T care pathway with the timings and roles which would ideally be involved in each part of the process., (© 2022. The Author(s).)

Copyright of Gaceta de la Real Sociedad Matematica Espanola is the property of Real Sociedad Matematica Espanola and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Chronic pancreatitis is a chronic fibroinflammatory disease of the pancreas with prevalence around 50 cases per 100,000 inhabitants. It appears to originate from diverse and yet mixed etiological factors. It shows highly variable presenting features, complication types and disease progression rates. Treatment options are as wide as the multiple personalized scenarios the disease might exhibit at a given time point. Some medical societies have developed guidelines for diagnosis and treatment based on scientific evidence. Although these efforts are to be acknowledged, the gathered level of evidence for any topic is usually low and, therefore, recommendations tend to be vague or weak. In the present series of position papers on chronic pancreatitis from the Societat Catalana de Digestologia and the Societat Catalana de Pàncrees we aimed at providing defined position statements for the clinician based on updated review of published literature and on interdisciplinary expert agreement. The final goal is to propose the use of common terminology and rational diagnostic/therapeutic circuits based on current knowledge. To this end 51 sections related to chronic pancreatitis were reviewed by 21 specialists from 6 different fields to generate 88 statements altogether. Statements were designed to harmonize concepts or delineate recommendations. Part 1 of this paper series discusses topics on aetiology and diagnosis of chronic pancreatitis. Main clinical features are abdominal pain, exocrine and endocrine insufficiency and symptoms derived from complications. Some patients remain symptom-free. Diagnosis (definitive, probable or uncertain) should be based on objective data obtained from imaging, histology, or functional tests., (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)

Social life cycle assessment (S-LCA) is a tool to address social impacts from a life cycle perspective. This work presents the first S-LCA of the Portuguese pulp and paper sector. It presents the social risks and the positive social impacts of the sector, which have not been extensively covered in the scientific literature. Two different approaches were used to compile the social life cycle inventory based on input-output analysis. Approach 1 was based on impact analysis of changes in added value. Approach 2 was based on structural path analysis, supporting the disaggregation by production levels (or tiers). The functional unit was the production of 1 United States Dollar in the Portuguese pulp and paper sector. In the social life cycle impact assessment, the social risk assessment was conducted using the Social Hotspots Database. The positive impacts were addressed considering indicators of employment and remuneration, namely total employment, number of employees, labor compensation, and compensation of employees. Based on Approach 1, the results of the social risks showed the Portuguese pulp and paper industry, commerce and forestry sectors, and the Spanish forestry sector as the critical sectors. Based on Approach 2, Portugal and Spain continued to be the countries having the greatest social risks. Other contributions of countries were identified at different production levels, particularly China in tier 3. In both approaches, the stakeholder category 'worker' was the most critical. Regarding the positive social impacts, Approach 1 showed that Portugal and Spain contribute to the highest employment level linked to the pulp and paper, commerce, and forestry sectors. Approach 2 supported the differentiation of employment and remuneration at different production levels. Tier 2 (direct suppliers) presented the highest employment level and persons engaged and the lowest remuneration level. The results showed that Approach 1 provides a faster and more aggregated assessment of social risks and positive social impacts. Furthermore, Approach 2 allowed a more detailed evaluation, providing a better understanding of the social risks and positive social impacts on the supply chain. Thus, Approach 2 is encouraged for different applications since it produces a better understanding of where social risks and positive social impacts occur, providing better guidance for corrective measures and decision-making. [ABSTRACT FROM AUTHOR]

The Spanish Association of Administrative Law Professors (AEPDA) will organize the XIX AEPDA Congress at the University of Lleida on January 31st and February 1st, 2025. The theme of the congress will be "Water Law in Spain: Forty Years Later". Communications and posters are invited to be submitted for the congress, with a deadline of December 10th, 2024. The call for communications and posters, as well as the provisional program of the congress, are attached. [Extracted from the article]

A deeper understanding of what factors influence metacognition has never become more pressing than in today's digital era, in which information flows constantly and quickly. To this end, the present study explored the role of culture in mediating how individuals experience metacognitive phenomena. For this purpose, the International Group on Metacognition (IGM) developed a rigorous standard international protocol to measure metacognition in Spanish-speaking university students (N = 1,461) in 12 cultures in Latin-America and Spain, employing both a subjective measure of metacognitive awareness (the Metacognitive Awareness Inventory [MAI]) and various metrics of objective metacognitive monitoring across three domains of learning—vocabulary, probabilities (mathematical reasoning), and paper folding (visual-spatial reasoning). Data were subsequently compared across the various cultures with subjective metacognitive awareness and the raw frequencies of the four mutually exclusive cells of the 2 × 2 performance/judgment array as outcomes. Results revealed significant differences regarding both macro-level components of subjective metacognitive awareness, knowledge and regulation of cognition. Further, significant and meaningful differences emerged for the raw frequencies of the four mutually exclusive cells as a function of culture, especially for vocabulary, in which differences among cultures emerged for all four cells. Implications for metacognitive research, theory, and practice are discussed. [ABSTRACT FROM AUTHOR]

Copyright of Aula (0214-3402) is the property of Ediciones Universidad de Salamanca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This position paper, sponsored by the Asociación Española de Gastroenterología [Spanish Association of Gastroenterology], the Sociedad Española de Endoscopia Digestiva [Spanish Gastrointestinal Endoscopy Society] and the Sociedad Española de Anatomía Patológica [Spanish Anatomical Pathology Society], aims to establish recommendations for performing an high quality upper gastrointestinal endoscopy for the screening of gastric cancer precursor lesions (GCPL) in low-incidence populations, such as the Spanish population. To establish the quality of the evidence and the levels of recommendation, we used the methodology based on the GRADE system (Grading of Recommendations Assessment, Development and Evaluation). We obtained a consensus among experts using a Delphi method. The document evaluates different measures to improve the quality of upper gastrointestinal endoscopy in this setting and makes recommendations on how to evaluate and treat the identified lesions. We recommend that upper gastrointestinal endoscopy for surveillance of GCPL should be performed by endoscopists with adequate training, administering oral premedication and use of sedation. To improve the identification of GCPL, we recommend the use of high definition endoscopes and conventional or digital chromoendoscopy and, for biopsies, NBI should be used to target the most suspicious areas of intestinal metaplasia. Regarding the evaluation of visible lesions, the risk of submucosal invasion should be evaluated with magnifying endoscopes and endoscopic ultrasound should be reserved for those with suspected deep invasion. In lesions amenable to endoscopic resection, submucosal endoscopic dissection is considered the technique of choice., (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)

We carry out mesoeconomic and mesoanalytical analyses of the structure and economic dimension of the book production process in Spain. For this report, the following have been carried out: (1) 43 in-depth interviews with experts have been conducted; (2) the information provided by Panorámica de la edición española from 1996 to 2019 has been systematized; (3) financial information from 2,683 companies for the period 2019-2021 has been obtained through the Sistema de Análisis de Balances Ibéricos. The report contains: (1) an original and rigorous way of analyzing the book production process in Spain; (2) novel quantitative and qualitative information about publishing companies, as well as their suppliers of goods and services: editorial services, packagers, graphic arts divisions, the paper industry, and software providers; (3) relevant information about the context in which book production takes place in Spain and the national and international institutions involved. [ABSTRACT FROM AUTHOR]

Copyright of Analisi: Quaderns de Comunicacio i Cultura is the property of Universitat Autonoma de Barcelona and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The concepts, premises, and promises of inclusive schooling as a global movement crystallized at UNESCO's 1994 World Conference on Special Needs Education in Salamanca. Despite their marked influence over the past 25 years, the Salamanca documents also ushered in a set of continuing challenges. Using the documents as a departure point, this paper addresses three main areas: UNESCO's role in erecting an architecture for inclusive schooling; core issues that arose in the Salamanca documents, particularly relating to contentious debates about the audience for inclusive schooling; and continuing issues in interpreting the Salamanca directions.

To commemorate the 100th anniversary of the creation of the Instituto Cajal, we bring this thematic issue to honor Spanish neuroscience. The issue includes several papers written by scientists, most of them being direct descendants of those who lived on the front lines of the dawn of Spanish neuroscience. These pages reflect a summary of the main achievements of this unique group of neuroscientists, all of them belonging to the Cajal School. Finally, this school of scientists became the forerunner of the modern worldwide neuroscience. Anat Rec, 303:1179-1180, 2020. © 2020 American Association for Anatomy., (© 2020 American Association for Anatomy.)

In the last few years, there are an increased number of families following a vegetarian diet, including their children. In order to guarantee child heath, paediatricians need to know the characteristics of this diet and the main foods that are used. There are few data on the medium and long-term health outcomes when removing all animal foods from the child's diet, especially at younger ages. Nevertheless, new tools have recently become available to facilitate following a vegetarian diet and decreasing the risk of deficiencies. In this document, the group of foods commonly used in vegetarian diets are reviewed, as well as recommendations for each age group. It also mentions the need to use B 12 supplements at all ages, as well as other nutrients (iodine, iron, vitaminD 3 , poly-unsaturated fatty acid n-3), when required. A vegetarian or a vegan diet, as in any other kind of diet, needs to be carefully designed. After reviewing current evidence, even though following a vegetarian diet at any age does not necessarily mean it is unsafe, it is advisable for infant and young children to follow an omnivorous diet or, at least, an ovo-lacto-vegetarian diet., (Copyright © 2019 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.)

The present study is a scientometrics evaluation of refereed publications on bacterial mastitis in sheep; the objectives were the evaluation of the relevant papers and the presentation of quantitative characteristics regarding their scientific content and bibliometric details. The Web of Science platform was used with search terms: [mastitis OR *mammary infection*] AND [sheep OR ewe* OR ovine] for papers from 1970 tο 2019; only 'articles', 'reviews', 'proceedings papers', or 'data papers' were evaluated, whilst documents related solely to contagious agalactia, mammary aspects of lentiviral infections, or infections of the teats and the udder skin were excluded. Finally, 580 papers were considered in detail. The number of published papers increased from 8 during the 1970s to 273 during the 2010s. These papers originated from 43 countries (most from Greece or Spain, n = 87 from each) and 240 institutions (145 universities and 95 other establishments), of which 35 produced ≥ 5 papers each. Most papers present original studies (n = 539) with a few reviews (n = 41). The original papers refer to dairy (n = 428), meat (n = 113), or wool (n = 1) production systems and present field (n = 329), laboratory (n = 163), or experimental (n = 67) work; the papers report aetiology (n = 146), risk factors (n = 100), pathogenesis (n = 92), diagnosis (n = 88), effects (n = 66), treatment (n = 50), control (n = 36), or descriptive epidemiology (n = 32) of the disease. Papers related to dairy production present more field and fewer experimental work than papers related to meat production; also, in papers describing work performed in dairy sheep, studies about aetiology, risk factors, and diagnosis of the disease predominate, whilst in papers performed in meat sheep, studies about aetiology, pathogenesis, and effects/diagnosis are reported more often. The papers were published in 175 scientific journals (most in Small Ruminant Research, n = 90, or Journal of Dairy Science, n = 54). On average, the papers received 16.8 total citations and 1.6 yearly citations (h-index = 47). Most papers were published in Scimago classification Q1 (n = 240) or Q2 (n = 230) journals and received 23.4 or 15.4 total citations, respectively. Reviews received more citations than original papers; among the latter, papers with work referring to dairy production received more yearly citations than papers referring to meat production; no differences in citations were seen according to type of work or mastitis aspect covered. Most citations were received by papers from France. Papers published in Journal of Dairy Science or Small Ruminant Research received the most citations. In total, there were 1558 individual authors of the papers, with 24 authors having co-authored > 10 papers each (max: 73 papers); on average, there were 5.2 co-authors per paper (min–max: 1–25). Average number of co-authors progressively increased from 2.1 in the 1970s to 6.3 in the 2010s, with original papers having a higher number of co-authors than reviews: 5.3 and 3.7, respectively. Papers from France had highers number of co-authors (7.9). The findings of this first ever scientometrics study into ovine mastitis indicate that the disease has not been studied as other sheep diseases and that future studies in it should be directed to its control. [ABSTRACT FROM AUTHOR]

The pandemic has disrupted students' lives, learning, and well-being worldwide and exacerbated existing disparities in education. Countries have unevenly followed policy recommendations to ensure education by non-governmental agencies, and in some cases, political and economic ideology has directly influenced the decisions taken, Spain being a case in point. The instructions and regulations published in April 2020 in Spain are analysed and compared in order to regulate the end of the school year, its evaluation, and the start of the new year, given the situation of suspension of classes during and the confinement of the Spanish population decreed due to the COVID-19 pandemic. The 20 documents published by the Autonomous Communities of Spain are subjected to critical discourse analysis. Their approaches and the aspects they highlight or ignore are examined to identify the different models of education that each region defends in times of crisis. There are significant differences between conservative and progressive regions, the latter being more inclined to implement the recommendations of non-governmental organisations.

Copyright of Profesorado: Revista de Currículum y Formación del Profesorado is the property of Profesorado: Revista de Curriculum y Formacion del Profesorado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Tejuelo: Didáctica de Lengua y Literatura is the property of Tejuelo. Didactica de la Lengua y la Literatura. Educacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Improvements in survival among cancer patients have revealed the clinical impact of cardiotoxicity on both cardiovascular and hematological and oncological outcomes, especially when it leads to the interruption of highly effective antitumor therapies. Atrial fibrillation is a common complication in patients with active cancer and its treatment poses a major challenge. These patients have an increased thromboembolic and hemorrhagic risk but standard stroke prediction scores have not been validated in this population. The aim of this expert consensus-based document is to provide a multidisciplinary and practical approach to the prevention and treatment of atrial fibrillation in patients with active cancer. This is a position paper of the Spanish Cardio-Oncology working group and the Spanish Thrombosis working group, drafted in collaboration with experts from the Spanish Society of Cardiology, the Spanish Society of Medical Oncology, the Spanish Society of Radiation Oncology, and the Spanish Society of Hematology., (Copyright © 2019 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

The childhood immunization schedule is well known and generally well implemented in developed countries. For various reasons, the same is not true of vaccines aimed at preventing infections in adults, in which vaccination coverage is incomplete and generally very deficient. In order to assess the situation of adult vaccination in Spain, the Fundación de Ciencias de la Salud has brought together a series of experts in different fields, including doctors, nurses, representatives of patient associations, health managers and economists, health authorities and journalists to deal with this issue. The format was that of a round table in which a series of questions previously formulated by the coordinators were to be answered and debated. The document presented is not an exhaustive review of the topic, nor is it intended to make recommendations, but only to give a multidisciplinary opinion on topics that could be particularly debatable or controversial. The paper reviews the main vaccine-preventable adult diseases, their clinical and economic impact, the possibilities of reducing them with vaccination programmes and the difficulties in carrying them out. The role of nursing, pharmacy services, patient associations and the health administration itself in changing the current situation was discussed. Prospects for new vaccines were discussed and we speculated on the future in this field. Finally, particularly relevant ethical aspects in decision-making regarding vaccination were discussed, which must be faced by both individuals and states. We have tried to summarize, at the end of the presentation of each question, the environment of opinion that was agreed with all the members of the table., (©The Author 2019. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)