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Several studies have explored the use of iconic gestures to improve the learning of foreign vocabulary. In this quest, words for abstract concepts have been largely neglected, under the assumption that abstract concepts have poor or non-existent sensory-motor representations. Yet, the Conceptual Metaphor Theory suggests that they are grounded on concrete concepts. Moreover, analyses of signed languages reveal ways in which signs can exploit metonymies and conceptual metaphors to iconically refer to abstract concepts. Here, we explore whether iconic signs from Spanish Sign Language (LSE) can facilitate the learning of foreign words for abstract concepts in hearing participants who do not know any sign language. In two studies, participants were presented with new labels for abstract and concrete concepts in an artificial language (Vimmi). The labels could be accompanied by either a video of an iconic or non-iconic sign taken from the existing vocabulary of LSE, or a static image of the signer. In study 1, participants did not have to enact the signs they were presented with, while in study 2 they did. Both studies showed that iconic signs facilitated the learning of abstract foreign vocabulary, regardless of enactment. The strategies that sign languages use to develop iconic signs for abstract concepts make those signs useful to assist the learning of foreign words by hearing non-signers.

Adolescents' relationship with technology is controversial both because of the possibilities it offers and because of the risks it entails, even being perceived by them as a real need. In order to improve the knowledge about it, a non-experimental research of transversal style has been carried out using a methodology based on data mining. 1,048 students of Secondary Education participated and answered a questionnaire about their use of the Internet and social networks. Six factors were identified, which could be recognized as patterns of behavior in the network. They are grouped around: (1) the communicative and informative dimension of the resources; (2) the one related to the security in the network; (3) the risk and vulnerability; (4) the specialized information both general and specific, (5) the transfer and acquisition of goods; and (6) the leisure and parental surveillance. The main findings show that their habits are mostly oriented towards the transfer and transaction along with the maintenance of security, avoiding situations that could involve risk and vulnerability in navigation. The identification of these subgroups is timely to develop training and digital literacy actions.

The excessive use of ICTs is a growing problem among young people. The social isolation caused by COVID-19 can increase these inappropriate behaviour. This study aims at analysing the problematic use of ICTs in trainee teachers based on the gender variable before and after the COVID-19 lockdown based on the gender variable. A longitudinal panel design was carried out with pre-test and post-test measurements based on the gender variable. The sample consisted of 147 students from the Faculty of Education at the University of Malaga who were tested using a validated instrument: MULTICAGE-TIC. The results show that women used ICTs at a higher risk than men before lockdown, except for video games. During lockdown, men obtain higher scores than women in all the analysed ICTs (except for mobile phones). Both genders reach dependency level in all ICTs except for video games in women. The significant increase in all ICTs shows that the effects of the pandemic, such as restrictions on mobility and social interaction, have influenced such growth.

Purpose: The aim of this paper is to explore whether the use of an active learning methodology implemented through a mobile phone can help future teachers to develop more effective reading promotion activities than those based on traditional learning methodologies. Design/methodology/approach: A study was conducted based on the comparison of perceptions of two groups of teacher training students. The experimental group was trained in an active methodology to promote reading on mobile phones, whilst the control group was trained in a classical methodology also using the same devices. Variables were observed using a self-administered questionnaire, and the scores obtained were analysed from their descriptive statistics of the comparison of means of Kruskal-Wallis H test. Findings: The results showed that students perceived significant improvements associated with active learning methodology. The variables with the most remarkable results were those related to better use of the class, participation and satisfaction. However, the ubiquitous variable obtained the fewest differences, maybe because both learning methodologies were applied using mobile devices. Originality/value: The conclusions of this study clearly suggest that combining active learning methodologies and the use of mobile phones to promote reading could lead to better results than applying traditional learning methodologies. The value of this study paves the way for future research to move forward in the discovery of effective teaching strategies based on active methods and mobile devices.

In increasingly diverse cultural contexts, the intercultural perspective favors an enriching coexistence between cultures, with volunteering being an exercise that allows for a critical transformation of reality in order to achieve a more supportive and equitable society. This article aims to find out how university students conceive of volunteering, as well as their level of participation. The sample was made up of 208 students from the Pedagogy and Social Education degrees of the University of Granada during the 2019/2020 academic year. An ad hoc questionnaire was applied, which incorporated a standardised instrument (Adapted Values Test), as well as questions designed by the authors. The results underline the positive axiological perception of volunteering. The participants understand volunteering as a helping role that depends on the social, personal, and professional motivations of the students. However, this positive perception is not transformed into active participation and continuous links with voluntary organisations. The conclusions indicate that university students value volunteering as a necessary task for the social good, although their participation is low, and it is necessary to transform the pro-social awareness of university students into real participation.

The type of tests used most by Primary Education teachers in the Spanish education system is traditional examinations, despite not fulfilling the educational qualities that pedagogy and the Spanish law prescribe for assessment processes. In this study, an assessment test has been designed by applying game-design elements to examinations of the Natural Sciences subject of Spanish Primary Education, considering the potential games have for learning at school. A sample of 217 teachers divided into two groups was studied. Teachers who agreed to apply gamification in class were included in the experimental group and teachers who declined to apply gamification were included in the control group. Both groups answered a questionnaire on their perception of how each type of assessment influenced different didactic aspects. The comparison of the traditional assessment model and the game-based model revealed that the gamified exam presented notable advantages associated with increased motivation and increased capacity of the assessment activity to continuity the learning process beyond the school context.

Smartphones are indeed becoming an essential tool in the daily lives and relations of their users in recent years, thanks to their uses and potential. However, excessive and inappropriate use can lead to dependence syndromes. The objectives of our study were to ascertain how these devices are being used and whether students are at risk of addiction. The study was carried out based on a survey with students--future teachers--from two Spanish universities. A sample of 453 students between the ages of 18 and 47 was analyzed, 76.8% female and 23.2% male. Smartphones were found to be the preferred Internet connection device for 80% of students, 38% of students connect to the Internet five hours or more a day (which can be considered an addiction) and smartphones are used primarily to connect with others (social media and instant messaging). The abusive use of smartphones affects men's behavior more than women and can lead them to neglect other activities, while smartphones affect women more in the emotional field, in matters related to boredom, impatience, and irritability.

Integrating technology into assessment processes in university contexts can change educational practices, in some cases by fostering self-regulated learning and in others by enabling more interactivity and participation among users. In this paper, we examine the opportunity to use electronic rubrics (erubrics) to assess learning. We report a student perception analysis on the process of assessment with electronic rubric at the university level. In this study, erubrics are applied in a Preschool (3-6 year-olds) and Primary Education (6-12 year-olds) pre-service teacher context. 87 students from two Spanish universities enrolled in a quarterly course of Education Technologies in the Faculty of Education used erubrics (©Gtea) for self- and peer assessment. Through a satisfaction survey, the study concluded that electronic rubric is an assessment facilitating resource for students as participants in the assessment process. Students tend to be satisfied with their use in both self- and peer assessment and acknowledge certain advantages regarding rubric features, implementation process and impact on learning process.

Background: Physical restraint is applied in pediatric intensive care units to carry out certain painful procedures and to ensure the maintenance and continuity of life support devices. There is a need to analyse the factors that influence the behaviour or intention to use physical restraint. Aim: To create and test psychometrically a paediatric version of the Physical Restraint‐Theory of Planned Behaviour Questionnaire to assess paediatric critical care nurses' intention to use physical restraint. Study Design: A psychometric study. Five medical‐surgical Paeditric Intensive care Units from five hospitals in Spain. The study took place in three phases. In phase 1, the questionnaire was adapted. In phase 2, the content validity of each item was determined, and a pilot test was conducted. In phase 3, we administered the questionnaire and determined its psychometric properties. Results: The assessment of the intention to use physical restraint was extended to all critical paediatric patients, two items were eliminated from the initial questionnaire, four new items were included, and the clinical scenarios of the intention subscale were expanded from three to six. Overall content validity index for the full instrument of 0.96 out of 1. The Paediatric Physical Restraint‐Theory of Planned Behaviour Questionnaire is made up of four subscales (attitude, subjective norms (SN), perceived behavioural control (PBC), and intention) subdivided into 7 factors and 51 items. The internal consistency for the attitude subscale obtained a Cronbach's Alpha of 0.80 to 0.73, for the SN it was 0.72 to 0.89, for the PBC it was from 0.80 to 0.73 and for the intention subscale it was 0.75. Conclusions: The Paediatric Physical Restraint‐Theory of Planned Behaviour Questionnaire is an instrument composed of seven factors and 51 items that validly and reliably assesses the intention of paediatric nurses to apply PR in PICUs. Relevance for Clinical Practice: Having this instrument will help health centres move towards restraint‐free care by allowing managers to assess professionals' attitudes, beliefs, and intentions around the use of PR in PICUs. [ABSTRACT FROM AUTHOR]

The implementation and sustainability of evidence-based practice (EBP) is a complex process. Best practice guidelines (BPGs) can facilitate the translation of knowledge from theory into practice, but they require working groups to adapt recommendations and encourage adherence to them. The aim of this study was to identify facilitators and barriers of BPGs in the Registered Nurses' Association of Ontario®, within the framework of Best Practice Spotlight Organisations® (BPSOs®), in a hospital setting. Methods: This study was conducted using the modified Delphi method (two rounds) with a cohort of BPSO® Best Practice Champions. The facilitators and barriers included in the first round were identified through a bibliographic search. The degree of concordance was determined in the second round using the highest mean resulting values. Results: A total of 44 nurses responded, with a mean age of 42.57 ± 8.563. The facilitators included the following: work environment; working in a hospital that encourages research; and dedicating time to EBP (p < 0.001). The barriers included the following: excessive workload; professional mobility (p < 0.001); and lack of time (p = 0.002). Implications for practice: As such, it is necessary to approach human resource management by implementing new policies that guarantee systemic sustainability. The BPSO® programme is an excellent framework for promoting the translation of theoretical knowledge into practice and effecting institutional change. [ABSTRACT FROM AUTHOR]

The objective of this research is to ascertain whether new instructional techniques can improve critical thinking. To achieve this goal, two different instruction techniques (ARDESOS--group 1--and DIAPROVE--group 2--) were studied and a pre-post assessment of critical thinking in various dimensions such as argumentation, inductive reasoning, causal, analogic, and deductive reasoning, decision-making and problem-solving was conducted. The results show that both forms of instruction functioned as expected. Both groups improved in all the dimensions of critical thinking. However, the group with the new technique was only better in two dimensions with respect to group 1, namely in deductive and inductive reasoning, but not in problem-solving and decision-making. One possible reason accounting for this discrepancy was our inability to implement the new methodology in all dimensions, such that it was applied where there was greater improvement in group 2 than in group 1. The implications of this study are important because they allow us to know which new variables are crucial for instructional methodology.

Research skills are part of the academic activities of Higher Education teachers. Regardless of the knowledge area they teach, there is a need to observe, reflect, select, analyse and communicate scientific results using technological advances. The aim of this study is to analyse the use that teachers make of different ICT resources for research in terms of gender, comparing within each gender the different areas of knowledge to which the teachers belong (Science and Engineering-Architecture, Health Sciences, Art-Humanities and Social-Legal Sciences). To this end, an ex post facto design through surveys was used with a sample of 867 university teachers in the Spanish education system. For the comparative analysis, univariate ANOVA by multiple comparisons was used. The findings revealed that teachers have, in general terms and in both genres, an average level of use, highlighting more use in digital databases, academic Google, high-impact journal websites, and very little use in data analysis software, mainly in qualitative software. The results highlighted that the Engineering-Architecture area is the one that makes the greatest use of ICT for research in comparison with the Art-Humanities area which uses ICT resources the least. The results demonstrate the need to develop procedural and cognitive skills in teaching staff in the most needed areas, not only to encourage them to continue researching and sharing the results acquired, but also to attend and prepare students in research skills so that they can continue learning and increasing their academic and professional training once the university stage is over.

In previous works we developed and assessed a teaching program, ARDESOS v.1, with which we aimed to improve the fundamental skills of critical thinking. The results obtained were positive, but modest. After analyzing the limitations of the program we introduced certain modifications and assessed the new version. The changes involved designing the activities programmed by means of rubrics and making the students perform them with less direct orientation from the instructor. In sum specificity and initiative proved to be the key variables in the improved program, ARDESOS v.2. Based on the data collected we have seen a significant improvement of the new version over the old one in the following aspects: a) version 2 improved all the fundamental dimensions, mainly in the pre-and post-test measurements, to a significant extent (Student's t test); b) the effect size (Cohen's d) was significantly higher, and finally c) these improvements in the program elicited better performance. Accordingly, an improvement in critical thinking can be achieved via an instruction design that addresses the factors that really induce change. Currently, with these results we have been successful in adding a new improvement to the instruction, which we have re-evaluated.

(1) Background: This study explores the potential energy expenditure associated with participation in after-school sports activities among primary school children. (2) Methods: The study involved 129 children age (11.35 ± 0.55 years) recruited from eight different public after-school sport programs. (3) Results: Data analyses revealed significant differences between the eight sports in total calories per session, calories per minute, and METs (p < 0.05). All sports showed higher energy expenditure compared to chess (p < 0.05), with soccer and rugby exhibiting the highest energy expenditure per session. Team sports showed elevated energy consumption per session (p < 0.01, r > 0.30), calories per minute (p = 0.01, r > 0.40), and METs (p < 0.01, r > 0.40) in comparison with individual sports. (4) Conclusions: These findings enhance our understanding of the energy expenditure observed in primary school children following various after-school sports activities. The results indicate that team sports, in particular, are pivotal in elevating physical activity levels, thereby playing an essential role in fostering healthier lifestyles among children. [ABSTRACT FROM AUTHOR]

Importance: Contextual elements at school playgrounds compromise the right to play. An occupation-based social transformation project to foster occupational justice in play at a school playground was conducted. Objective: To better understand barriers to and facilitators of children's participation in occupations at the school playground to co-create actions that enable play. Design: A participatory methodology—Photovoice—was used. The research consisted of four phases: involving the community in the research design, community-led data generation and analysis, discussion of findings to increase the community's awareness, and a community agenda for changing the playground. Setting: Public primary school playground in northwest Spain. Participants: All children (n = 450, ages 3–12 yr), families (n = 12), and teachers (n = 15) participated. A thematic analysis of visual, textual, and oral material was conducted, including member checking. Results: The study revealed several barriers to play, including the short recess duration, poor floor (surface) conditions, jail-like atmosphere, and violence. However, participants identified an ad hoc lending games system and playground murals advocating for children's rights as facilitators. These findings have direct implications for improving the play environment. Conclusions and Relevance: Conflicting priorities between children's and adults' desires and needs for the playground were unveiled, displaying the relevance of invisible contexts (i.e., social or institutional contexts) in shaping play opportunities. A critical occupational stance combined with a participatory and playful methodology generated space to unveil these conflicting priorities, reconcile agendas, raise awareness, and propose collective actions to transform the playground. Plain-Language Summary: Playing is fundamental to children's development and inclusion. This study focused on making school playgrounds better places for kids to play. Researchers found that things such as short playtimes, bad playground conditions, and violence made it tough for kids to enjoy playing, but they also discovered some good things, such as a system for borrowing games and colorful murals promoting children' rights. These findings show that changing the playground's physical and social environment can make a big difference for kids. By listening to kids and working together, adults and children can create playgrounds where all kids can play meaningfully and safely. Occupational therapists can promote such processes. Changing a playground's physical and social environment can create better places for kids to play. [ABSTRACT FROM AUTHOR]

Background: The low prevalence of rare diseases poses a significant challenge in advancing their understanding. This study aims to delineate the clinical and genetic characteristics of patients with rare eye diseases (RED) enrolled in the Spanish Rare Diseases Patient Registry. Methods: A total of 864 patients from the registry database were included. Diseases were categorized into inherited retinal dystrophies (n=688); anterior segment diseases (n=48); congenital malformations (n=27); and syndromic diseases with ocular involvement including muscular (n=46), neurological (n=34), or metabolic (n=13); inflammatory diseases (n=4); and tumors (n=4). Data on visual acuity (VA) and/or visual field (VF), symptoms and signs, concurrent diseases in syndromic cases, age of onset and at diagnosis, affected genes, disability rating, inability to work and dependency grade recognition were collected. Results: A mean diagnostic delay of 7 years from symptom onset was observed. Commonly reported symptoms included photophobia, night blindness, and progressive vision loss (≥57% of patients). Cataract was the most prevalent secondary disease (46%), with pseudophakia being the most common ocular surgery (26%). Hearing loss and cardiovascular diseases were the most prevalent concurrent systemic diseases (≥13%). Certificates of disability, incapacity for work, and dependency were held by 87%, 42%, and 19% of patients, respectively. Among the 719 patients with available VA data, 193 (27%) were blind, and 188 (26%) had moderate to severe visual impairment. Over half of the patients (54%) exhibited VF defects, and 216 (25%) had concentric contraction ≤5° or abolished VF. Most had genetic diseases with autosomal recessive (55%), autosomal dominant (30%), X-linked (9%), and mitochondrial (6%) patterns. One patient had mutations in both recessive USH2A and dominant RHO genes simultaneously. Of the 656 patients (75.7%) who underwent genetic testing, only 461 (70.3%) received a positive result (pathogenic or likely pathogenic mutations explaining the phenotype). We found 62 new gene variants related to RED not previously reported in databases of genetic variants related to specific phenotypes. Conclusions: This study delineates the clinical and genotypic profiles of RED in Spain. Genetic diseases, particularly retinal disorders, predominate, but a significant proportion of affected patients remain genetically undiagnosed, hindering potential gene therapy endeavors. Despite notable improvements in reducing diagnosis delays, it is still remarkable. RED frequently lead to disability and blindness among young populations. [ABSTRACT FROM AUTHOR]

This paper addresses attitudes around the projection of the EU among Latin American elites, namely the determinants of support for a Free Trade Agreement between the two regions and the trustworthiness of the EU government. We take as data elite surveys conducted in 15 Latin American countries (2014–2019) and consider sociodemographics, ideology, support for democracy, views of foreign powers, exports to the EU, and electoral democracy. Results show that ideology and support for democracy are key determinants of support for an interregional FTA, and that the trustworthiness of governments in the US, China, and Spain covary with attitudes toward the EU. The latter (trust in the government in Spain) proves to be the main driver and, furthermore, its impact is conditional on the economic strength (observed as exports) of the EU: wherever the EU is not a strong economic actor in Latin America, trust in the Spanish government does nothing but improve the image of the EU. [ABSTRACT FROM AUTHOR]

This study empirically compares domestic tourists' behavior before and after the Covid-19 outbreak. Specifically, official data are used to characterize the travel behavior of residents in Spain who traveled through this country for reasons of leisure, recreation, and vacations in 2019 and 2020. A discrete choice model is employed to unravel the main variables that influence the decision of being an inter-regional traveler. The bootstrap p -value method is used to detect significant changes in the marginal effect of the different variables after the Covid-19 outbreak. The estimation results demonstrate the following: (i) domestic inter- and intra-regional travelers have significant differences and, therefore, policy-makers should not design and implement "one size fits all" policies for domestic tourism; (ii) in addition to socio-economic factors, the regional push-pull factors (e.g., weather) and trip-related characteristics (e.g., type of accommodation) are also important in explaining inter-regional travel decisions; (iii) a high number of Covid-19 infections in the region of origin increases the probability of traveling inter-regionally; and (iv) the Covid-19 outbreak has caused an abrupt shift in domestic travelers' profiles. [ABSTRACT FROM AUTHOR]

Adolescence is characterized by the emergence of romantic interactions. This study aims to explore the psychometric properties of the Scale of Myths of Romantic Love (SMRL) and the gender differences in Spanish adolescents. The sample was representative and consisted of 1,840 third (52.8%) and fourth (47.2%) year students in compulsory secondary education in Castilla-La Mancha. In line with the original validation, the results of the factor analyses show that the SMRL is a mainly uni-dimensional measure when applied to adolescents. The bi-factor analysis yields satisfactory fit indices (in terms of GFI, AGFI, CFI, RMSEA, SRMR; Medrano & Muñoz-Navarro, 2017) and indicates that the general factor is more solid than the specific factors (in terms of ECV, ωh and H h ). Correlations with the Myths Scale toward Love and the Gender Equality Attitudes Scale provide evidence in favor of convergent and discriminant validity. Boys scored significantly higher than girls on the SMRL. In conclusion, this is a suitable instrument to scientifically address romantic myths at the adolescent stage, but also to complement and guide educational interventions. [ABSTRACT FROM AUTHOR]

It is desirable that reasoning, problem-solving and decision-making skills should form an integral part of our private and professional lives. Here we show how these skills can be improved through the use of the ARDESOS program. To test the effect of the program, we have also developed an assessment test (PENCRISAL). Our results are going in the desired direction. The ability to decide and make inductive inferences was improved, and this improvement was also seen in argumentation, although indirectly. In the future we must therefore improve our interventions in all factors, but in particular those referring to induction and problem-solving. Much remains to be done from the procedural point of view, but the preliminary results are very promising and we are convinced that our initiative has a good conceptual grounding. (Contains 2 tables and 1 figure.)

Game-based learning (GBL) has demonstrated its effectiveness in education by addressing challenges such as apathy, motivation, and active student engagement. In this article, the narrative video game "A Normal Lost Phone" has been employed to raise awareness among university students about transgender and gender diverse (TGD) individuals. The project involved 35 undergraduate students in Social Education from a university in Spain (29 females, 5 males, and 1 non-binary individual), with an average age of 20.52 years (SD = 1.82) during the academic year 2022/2023. The workshop's main objective was to enhance undergraduate students' training in social education and better prepare them for their future careers. The results highlight that video games can promote sensitivity and understanding of sexual and gender diversity among university students, which could have significant implications for professional training in this field. In conclusion, GBL presents promising opportunities for transforming educational practices. The integration of cooperative workshops into teaching methodologies can have a positive impact on student engagement, learning outcomes, and attitudes. Further research is needed to comprehend and effectively incorporate GBL into teaching practices fully. By harnessing the educational potential of games, we can create more engaging and effective learning environments that equip students with the necessary skills for their future careers in social education. [ABSTRACT FROM AUTHOR]

Background: Paediatric patients are especially prone to experiencing adverse drug reactions (ADRs), and the surgical environment gathers many conditions for such reactions to occur. Additionally, little information exists in the literature on ADRs in the paediatric surgical population. We aimed to quantify the ADR frequency in this population, and to investigate the characteristics and risk factors associated with ADR development. Methods: A prospective observational study was conducted in a cohort of 311 paediatric patients, aged 1–16 years, admitted for surgery at a tertiary referral hospital in Spain (2019–2021). Incidence rates were used to assess ADR frequency. Odds ratios (ORs) were calculated to evaluate the influence of potential risk factors on ADR development. Results: Distinct ADRs (103) were detected in 80 patients (25.7%). The most frequent being hypotension (N = 32; 35%), nausea (N = 16; 15.5%), and emergence delirium (N = 16; 15.5%). Most ADRs occurred because of drug-drug interactions. The combination of sevoflurane and fentanyl was responsible for most of these events (N = 32; 31.1%). The variable most robustly associated to ADR development, was the number of off-label drugs prescribed per patient (OR = 2.99; 95% CI 1.73 to 5.16), followed by the number of drugs prescribed per patient (OR = 1.26, 95% CI 1.13 to 1.41), and older age (OR = 1.26, 95% CI 1.07 to 1.49). The severity of ADRs was assessed according to the criteria of Venulet and the Spanish Pharmacovigilance System. According to both methods, only four ADRs (3.9%) were considered serious. Conclusions: ADRs have a high incidence rate in the paediatric surgical population. The off-label use of drugs is a key risk factor for ADRs development. [ABSTRACT FROM AUTHOR]

Simple Summary: This study assessed hypo-fractionated radiotherapy's feasibility and acute toxicity using the first Spanish 0.35T MR-LINAC in 37 patients. Prostate tumors (59.46%) were the most treated, followed by pancreatic tumors (32.44%). Treatment adaptation was successful, with manageable acute toxicity profiles. For prostate cancer, hypo-fractionated radiotherapy yielded promising outcomes with minimal toxicity, predominantly grade I and II cystitis. Pancreatic cancer patients received ablative dose radiotherapy with acceptable toxicity. Quality assurance measures demonstrated precise dose delivery. Overall, our study highlights the safety and feasibility of hypo-fractionated radiotherapy on a 0.35T MR-LINAC, particularly for challenging anatomical sites like prostate and pancreatic tumors, supporting its potential as an effective cancer treatment strategy. This observational, descriptive, longitudinal, and prospective basket-type study (Registry #5289) prospectively evaluated the feasibility and acute toxicity of hypo-fractionated radiotherapy on the first 0.35T MR-LINAC in Spain. A total of 37 patients were included between August and December 2023, primarily with prostate tumors (59.46%), followed by pancreatic tumors (32.44%). Treatment regimens typically involved extreme hypo-fractionated radiotherapy, with precise dose delivery verified through quality assurance measures. Acute toxicity assessment at treatment completion revealed manageable cystitis, with one case persisting at the three-month follow-up. Gastrointestinal toxicity was minimal. For pancreatic tumors, daily adaptation of organ-at-risk (OAR) and gross tumor volume (GTV) was practiced, with median doses to OAR within acceptable limits. Three patients experienced gastrointestinal toxicity, mainly nausea. Overall, the study demonstrates the feasibility and safety of extreme hypo-fractionated radiotherapy on a 0.35T MR-LINAC, especially for challenging anatomical sites like prostate and pancreatic tumors. These findings support the feasibility of MR-LINAC-based radiotherapy in delivering precise treatments with minimal toxicity, highlighting its potential for optimizing cancer treatment strategies. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to describe the use of the nursing diagnosis Risk for Falls in Primary Care System of the Community of Madrid. Methods: A retrospective review of the clinical histories was carried out in 262 health centers from January 2005 to December 2015. The study population are the patients who have recorded in their electronic health record the nursing diagnosis Risk for Falls. Findings: Frequency of use of the Risk for Falls ND in the Community of Madrid was 53,340 diagnoses, increasing from 650 nursing diagnosis in 2005 to 14,695 in 2015. NOC Nursing Outcomes total identified were 109,145, which represents an average of 2.05 NOC Nursing Outcomes per diagnosis. NOC Nursing Outcomes frequently appeared as follows: Fall Prevention Behavior (35.9%), Safe Home Environment (11.3%), and Risk Control (10.5%). NIC Nursing Interventions total identified were 104,293, representing an average of 1.96 NIC nursing interventions per diagnosis. NIC Nursing Interventions frequently appeared as follows: Fall Prevention (45.9%), Environmental Management: Safety (27%), and Risk Identification (5.8%). Conclusions: Nursing diagnosis of Risk for Falls and the care process related to this diagnosis is starting to be used by the primary care nurses of the Community of Madrid. Implication for nursing practice: Risk factors related to the nursing diagnosis of risk for falls identified in our study can be addressed with activities that nurses must implement to prevent falls. Nursing methodology in general and specifically the diagnosis of risk for falls must be included in guides and protocols for the prevention of falls, and its use should be promoted by primary care nurses. [ABSTRACT FROM AUTHOR]

Background: Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe. Male urogenital manifestations are often neglected. We aimed to ascertain the prevalence of genitourinary clinical signs and symptoms among long-term African migrants in a non-endemic European country using a serology test. Methods: We carried out a prospective, community-based cross-sectional study of adult male migrants from sub-Saharan Africa living in Spain. Schistosoma serology tests and microscopic urine examinations were carried out, and clinical data were obtained from an electronic medical record search and a structured questionnaire. Results: We included 388 adult males, mean age 43.5 years [Standard Deviation (SD) = 12.0, range: 18–76]. The median time since migration to the European Union was 17 [Interquartile range (IQR): 11–21] years. The most frequent country of origin was Senegal (N = 179, 46.1%). Of the 338, 147 (37.6%) tested positive for Schistosoma. Parasite eggs were present in the urine of only 1.3%. Nine genitourinary clinical items were significantly associated with positive Schistosoma serology results: pelvic pain (45.2%; OR = 1.57, 95% CI: 1.0–2.4), pain on ejaculation (14.5%; OR = 1.85, 95% CI: 1.0–3.5), dyspareunia (12.4%; OR = 2.45, 95% CI: 1.2–5.2), erectile dysfunction (9.5%; OR = 3.10, 95% CI: 1.3–7.6), self-reported episodes of infertility (32.1%; OR = 1.69, 95% CI: 1.0–2.8), haematuria (55.2%; OR = 2.37, 95% CI: 1.5–3.6), dysuria (52.1%; OR = 2.01, 95% CI: 1.3–3.1), undiagnosed syndromic STIs (5.4%), and orchitis (20.7%; OR = 1.81, 95% CI: 1.0–3.1). Clinical signs tended to cluster. Conclusions: Urogenital clinical signs and symptoms are prevalent among male African long-term migrants with a positive Schistosoma serology results. Genital involvement can be frequent even among those with long periods of non-residence in their sub-Saharan African countries of origin. Further research is needed to develop diagnostic tools and validate therapeutic approaches to chronic schistosomiasis. [ABSTRACT FROM AUTHOR]

In recent years, European journalists show a preference for opinionated stories in a growing movement triggered by the acceleration of the political information cycle in the digital sphere. This research aims to analyze how reporting the EU meets quality standards, comparing the coverage of EU affairs in local media from Germany, the United Kingdom (UK) and Spain. We content-analyze all the published news items on European issues, collected over a one-year period (2018–2019). Local media are selected because of their relationship with democracy in nearby communities. Based on a corpus of 1093 news stories, the results show that the number of statements was high; meanwhile, we detected a negative bias in every media outlet of the sample, but some differences were also found linking to national contexts. Likewise, our study provides evidence on the shaping of low-quality news about the EU, arguing that this practice could boost a polarized climate. [ABSTRACT FROM AUTHOR]

Background: This study aimed to validate the role of the D-dimer to lymphocyte ratio (DLR) for mortality prediction in a large national cohort of hospitalized coronavirus disease 2019 (COVID-19) patients. Methods: A retrospective, multicenter, observational study that included hospitalized patients due to SARS-CoV-2 infection in Spain was conducted from March 2020 to March 2022. All biomarkers and laboratory indices analyzed were measured once at admission. Results: A total of 10,575 COVID-19 patients were included in this study. The mean age of participants was 66.9 (±16) years, and 58.6% (6202 patients) of them were male. The overall mortality rate was 16.3% (n = 1726 patients). Intensive care unit admission was needed in 10.5% (n = 1106 patients), non-invasive mechanical ventilation was required in 8.8% (n = 923 patients), and orotracheal intubation was required in 7.5% (789 patients). DLR presented a c-statistic of 0.69 (95% CI, 0.68–0.71) for in-hospital mortality with an optimal cut-off above 1. Multivariate analysis showed an independent association for in-hospital mortality for DLR > 1 (adjusted OR 2.09, 95% CI 1.09–4.04; p = 0.03); in the same way, survival analysis showed a higher mortality risk for DLR > 1 (HR 2.24; 95% CI 2.03–2.47; p < 0.01). Further, no other laboratory indices showed an independent association for mortality in multivariate analysis. Conclusions: This study confirmed the usefulness of DLR as a prognostic biomarker for mortality associated with SARS-CoV-2 infection, being an accessible, cost-effective, and easy-to-use biomarker in daily clinical practice. [ABSTRACT FROM AUTHOR]

The given text provides a comprehensive list of plant communities and vegetation types found in the Sierra de Guadarrama National Park in Spain. It includes scientific names, classifications, and characteristics of each community. The text can be a valuable resource for researchers studying the biodiversity and ecology of the park. It is presented in a scientific format and can be explored further for more detailed information. [Extracted from the article]

The objective of the research was to study the presence of cyber violence against partners in university students in Spain and Latin America, as well as to analyze its relationship with romantic myths and ambivalent sexism. The research has a cross-sectional design. The sample was made up of 2,798 students from seven Spanish-speaking countries: Spain, El Salvador, Nicaragua, Colombia, Chile, Argentina, and Mexico. The results show few differences in means between men and women; However, the differences between countries are considerable, especially in the perpetration of direct attacks and control. The different forms of cyber violence against a partner tend to correlate, in a positive direction, with sexist attitudes and distorted beliefs about romantic love. In conclusion, prevention programs should take into account the new manifestations of violence that are appearing in virtual spaces. [ABSTRACT FROM AUTHOR]

This study was undertaken to analyze the relationship between the diagonal earlobe crease and the main indices of cardiovascular risk, considering the crease's anatomical variations. The study group consisted of 1050 adults residing in Spain. Participants underwent the following determinations: age, sex, body mass index, smoking habit, blood pressure, glycemia, glycated hemoglobin, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and cardiovascular events. Cardiovascular risk was calculated applying the Framingham-Anderson equation, the Systematic Coronary Risk Evaluation equation, and the Atherosclerotic Cardiovascular Disease Risk Score calculator. Both earlobes were examined, recording diagonal earlobe crease presence, length and depth, and presence of accessory creases. Results were analyzed by using chi-square test, Student's t test, analysis of variance, and Mann-Whitney or Kruskal-Wallis tests. To extract the functions of cardiovascular risk, a script in R was created (https://cran.r-project.org/). The estimated cardiovascular mortality risk was significantly higher in individuals who presented diagonal earlobe crease (P <.001). The number of individuals with moderate, high, or very high cardiovascular risk increased significantly as the presence of the crease increased (23.8% had no crease, 35.6% had unilateral creases, and 58% had bilateral creases; P <.001). The mean cardiovascular risk estimated was significantly higher for individuals with longest and deepest diagonal earlobe crease (P <.001 and P <.001, respectively), and with accessory creases (P <.001). The diagonal earlobe crease is independently associated with higher cardiovascular risk scores, especially when the crease is complete, bilateral, deep, and has accessory creases. [ABSTRACT FROM AUTHOR]

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Background: The availability of multiple treatments for type 1 Gaucher disease increases the need for real-life studies to evaluate treatment efficacy and safety and provide clinicians with more information to choose the best personalized therapy for their patients. Aims: To determine whether treatment with eliglustat produces, in adult GD1 patients, ans optimal response in daily clinical practice. Methods: We designed a real-life study with 2 years of follow-up (TRAZELGA [GEE-ELI-2017-01]) to uniformly evaluate the response and adverse events to eliglustat treatment. This study, conducted in 30 patients across Spain and previously treated with other therapies, included the evaluation of safety and efficacy by assessing visceral enlargement, bone disease (DEXA and T and Z scores), concomitant treatments and adverse events, as well as a quality of life evaluation (SF-36). In addition, the quantification of classical biomarkers (chitotriosidase activity, CCL18/PARC and glucosylsphingosine (GluSph)) and new candidates for GD biomarkers (YKL-40, cathepsin S, hepcidin and lipocalin-2 determined by immunoassay) were also assessed. Non-parametric statistical analysis was performed and p < 0.05 was considered statistically significant. Main Results: Thirty patients were enrolled in the study. The median age was 41.5 years and the male–female ratio was 1.1:1. 84% of the patients had received ERT and 16% SRT as previous treatment. The most common symptoms at baseline were fatigue (42%) and bone pain (38%), no patient had a bone crisis during the study, and two years after switching, 37% had reduced their use of analgesics. Patient-reported outcomes showed a significant increase in physical function scores (p = 0.027) and physical pain scores (p = 0.010). None of the enrolled patients discontinued treatment due to adverse events, which were mild and transient in nature, mainly gastrointestinal and skin dryness. None of the biomarkers show a significant increase or decompensation after switching. CCL18/PARC (p = 0.0012), YKL-40 (p = 0.00004) and lipocalin-2 (p = 0.0155) improved after two years and GluSph after one year (p = 0.0008) and two years (p = 0.0245) of oral therapy. Conclusion: In summary, this real-life study, showed that eliglustat maintains stability and can improve quality of life with few side effects. Significant reductions in classic and other novel biomarkers were observed after two years of therapy. [ABSTRACT FROM AUTHOR]

UNESCO-designated geoparks, intended for conservation, seek to drive economic development via geological heritage education and tourism. Since 2018, within the framework of the European project Atlantic Geoparks (Interreg Atlantic area program), the Valleys of Cantabria project has been promoted to declare a UNESCO Global Geopark (UGGp) in the Cantabria region (northern Spain). The Valles de Cantabria proposal, aligning with UNESCO objectives, evaluates the region's geopark potential, emphasizing sustainable development and societal education. Covering 600 km2 in eastern Cantabria, the territory involves 19 municipalities and has a population of 60,600. The geological context, ranging from the Triassic to the Quaternary periods, reflects the complex evolution of this territory, which has been influenced by tectonic forces, geomorphological processes, and sea-level changes. Detailed reviews and fieldwork performed by experts, including university researchers, have identified 66 sites of geological interest (SGI). The geosites, which have different geological–geomorphological significances, have been assessed according to their scientific value (including educational importance), potential of use (mainly geotouristic use), and vulnerability or risk of degradation. The geological heritage is directly related to the high biodiversity of the area. The challenges of this territory, such as depopulation and the low income of the inhabitants, can be improved with the declaration of a geopark, which would help to create new job opportunities related to geotourism and sustainable development. UNESCO recognition could catalyse scientific research, address socioeconomic challenges, and foster rural revitalization, strengthening the symbiotic relationship between geoconservation and local economic growth. Collaboration with other Atlantic geoparks has enabled the exchange of experiences that will hopefully deepen in the future. Consequently, the aim of this work is to explore the potential of this territory in terms of high-quality geological features and biological and cultural heritage, as well as to evaluate the socioeconomic context that makes the territory potentially suitable for promoting a UGGp. [ABSTRACT FROM AUTHOR]

This paper is dedicated to the work of British female travellers who visited Spain and, more specifically, Andalusia, from the 18th century to the present. Their works offer a sensitive, first-hand view that is different from that of their male contemporaries and, on numerous occasions, question or contradict the supposed myths, comments, and opinions of their compatriots, even those of renowned Hispanophiles as Richard Ford or George Borrow. Unfortunately, practically all the works on Spain by female travellers have remained forgotten, ignored, or silenced, and have not been translated into other languages. With the aim of making women's contributions to travel literature more visible, this paper offers an unpublished chronological list of women travellers in Andalusia and their works from the 18th century to the present, compiled thanks to consultations with the collections of the library of the Instituto Cervantes in London. As a sample of the sensitive and emotional vision that appreciates the essence of the rural and human landscape of Andalusia, compared to other technical accounts of male writers, we analyse Cositas Españolas, or Every Day Life in Spain (1875) by Annie Jane Harvey, a work not yet translated into Spanish and whose visibility we claim from this work. The study shows Harvey to be a privileged "observer", whose alternative vision to that of other male travellers proves an optimistic defence of the values of the Spanish people. [ABSTRACT FROM AUTHOR]

This article reveals the results of a research study that was carried out in Spain in 2012 with the purpose of discovering the influence of the gender variable on the incorporation of the Internet in the educational programmes of primary and secondary public education centres. By using a multiple case study carried out in situ, the research team has gathered information from the teaching staff entrusted with the process of incorporating the Internet into the educational programme at each school. It has also studied the way in which the use of the Internet in the classroom is specified. These sources have been subjected to triangulation techniques in order to increase the reliability of the results, which has enabled us to define the extent to which the gender of those running the educational implementation of the Internet in Spanish centres is influential. The results show that there are no significant differences between men and women as regards the introduction of the Internet into the educational programmes at the centres used in this study.

This paper analyses a particular socio-educational experience in a marginalised neighbourhood in Malaga, Spain. This initiative came about as an institutional proposal to combat neoliberal austerity policies and is known as the "Casa de la Buena Vida". It aims to generate new educational practices based on solidarity, dignity and justice. The methodology followed entailed carrying out an ethnography at this institution, participating in the initiative over a period of 4 years. At the same time, life histories of some of its most notable members were drawn up. In the results section we offer an analysis of the particular identities that are created as a consequence of the living conditions, social conflicts, multicultural nature and survival strategies that operate in a welfarist policy system. We also analyse this institution's socio-educational proposal using alternative social practices that enable other subjectivities to develop.

Limitations of formal learning (e.g., one-way communication, rigid methodology, results-oriented approach) can significantly influence the motivation and expectation of students, thus resulting in an academic progress reduction. In order to make learning processes more playful and motivating, this paper presents a new educational experience developed by two groups of Computer Science students at the University of Huelva (Spain). As a result, an authentic real experience was incorporated into the classical teaching of Artificial Intelligence courses where classroom sessions were changed during some days for an international online competition. A comprehensive study considering the competition ranking, the students' opinion and their academic progress was analysed to assess the followed methodology. We found out that the educational experience improved the students' motivation, thereby enhancing their academic performance and personal skills as a result of learning through play. Moreover, additional teaching goals (e.g., learning new programming languages or increasing exam attendance) were obtained because of the positive motivation experienced by the competition. As a conclusion, this paradigm of real-life experience--not otherwise provided by traditional practical lessons--allowed us to ascertain that the process is more important than the outcome, which could be adapted to different teaching scenarios within an institution.

Background Antimicrobial stewardship programs (ASPs) are recommended in nursing homes (NHs), although data are limited. We aimed to determine the clinical and ecological impact of an ASP for NHs. Methods We performed a cluster, randomized, controlled trial and a before–after study with interrupted time-series analyses in 14 NHs for 30 consecutive months from July 2018 to December 2020 in Andalusia, Spain. Seven facilities implemented an ASP with a bundle of 5 educational measures (general ASP) and 7 added 1-to-1 educational interviews (experimental ASP). The primary outcome was the overall use of antimicrobials, calculated monthly as defined daily doses (DDD) per 1000 resident days (DRD). Results The total mean antimicrobial consumption decreased by 31.2% (−16.72 DRD; P =.045) with respect to the preintervention period; the overall use of quinolones and amoxicillin–clavulanic acid dropped by 52.2% (P =.001) and 42.5% (P =.006), respectively; and the overall prevalence of multidrug-resistant organisms (MDROs) decreased from 24.7% to 17.4% (P =.012). During the intervention period, 12.5 educational interviews per doctor were performed in the experimental ASP group; no differences were found in the total mean antimicrobial use between groups (−14.62 DRD; P =.25). Two unexpected coronavirus disease 2019 waves affected the centers increasing the overall mean use of antimicrobials by 40% (51.56 DRD; P <.0001). Conclusions This study suggests that an ASP for NHs appears to be associated with a decrease in total consumption of antimicrobials and prevalence of MDROs. This trial did not find benefits associated with educational interviews, probably due to the coronavirus disease 2019 pandemic. Clinical Trials Registration. NCT03543605. [ABSTRACT FROM AUTHOR]

In 2020, the COVID-19 pandemic followed a two-wave pattern in most countries. Hospital admission for COVID-19 in one wave or another could have affected mortality, especially among the older persons. The objective of this study was to evaluate whether the admission of older patients during the different waves, before SARS-CoV-2 vaccination was available, was associated with a different mortality. We compared the mortality rates of patients hospitalized during 2020 before (first wave) and after (second wave) July 7, 2020, included in the SEMI-COVID-19 Registry, a large, multicenter, retrospective cohort of patients admitted to 126 Spanish hospitals for COVID-19. A multivariate logistic regression analysis was performed to control for changes in either the patient or disease profile. As of December 26, 2022, 22,494 patients had been included (17,784 from the first wave and 4710 from the second one). Overall mortality was 20.4% in the first wave and 17.2% in the second wave (risk difference (RD) − 3.2%; 95% confidence interval (95% CI) − 4.4 to − 2.0). Only patients aged 70 and older (10,973 patients: 8571 in the first wave and 2386 in the second wave) had a significant reduction in mortality (RD − 7.6%; 95% CI − 9.7 to − 5.5) (unadjusted relative risk reduction: 21.6%). After adjusting for age, comorbidities, variables related to the severity of the disease, and treatment received, admission during the second wave remained a protective factor. In Spain, patients aged 70 years and older admitted during the second wave of the COVID-19 pandemic had a significantly lower risk of mortality, except in severely dependent persons in need of corticosteroid treatment. This effect is independent of patient characteristics, disease severity, or treatment received. This suggests a protective effect of a better standard of care, greater clinical expertise, or a lesser degree of healthcare system overload. [ABSTRACT FROM AUTHOR]

Cabo Ortegal, in Spain, was declared a UNESCO Global Geopark in 2023. An ultramafic complex makes it a geologically exciting unit, where many research works have been carried out. Serpentinites, formed by the weathering of peridotites, dunites, and other ultramafic rocks, have been described in detail in previous works. Their role as a construction material has been elucidated, although due to their complexity and heterogeneity, the results of using these materials for construction are not always successful. Talcose rocks, related to serpentinites, can also be found in the complex, although it is difficult to distinguish them. Talcose rocks may be a resource to be explored and exploited in an unpopulated area. The use of talc in pharmaceuticals, cosmetics, and handicrafts makes it a material of growing importance. However, the asbestos and heavy metal content should be severely limited to prevent health issues. The goal of this work is to start the characterization of these talcose rocks before promoting their potential use in different contexts to support the economy of an underpopulated area of Spain. [ABSTRACT FROM AUTHOR]

Background: Health literacy and eHealth literacy play a crucial role in improving a community's ability to take care of themselves, ultimately leading to a reduction in disparities in health. Embracing a healthy way of living is vital in lessening the impact of illnesses and extending one's lifespan. This research delves into the link between the health and eHealth literacy levels of individuals accessing primary healthcare services and investigates how this relates to adopting a health-conscious lifestyle. Methods: The approach involves a cross-sectional examination carried out at a healthcare facility in the Madrid region of Spain, focusing on adult patients who are in need of primary care nursing services. Health and eHealth literacy and a healthy lifestyle were measured using the Health Literacy Questionnaire (HLQ), the eHealth Literacy Questionnaire (eHLQ), and the "PA100" questionnaire, respectively. Results: Only some of the dimensions of the HLQ and eHLQ were significantly related to a healthy lifestyle, predominantly with a very low or low relationship. Dimension three of the HLQ and dimension five of the eHLQ acquired more importance and were positioned as positive predictors of a healthy lifestyle. Conclusions: This study helps comprehend the relationship between health and eHealth literacy and a healthy lifestyle, which provides information that contributes to understanding the factors that might have a higher impact on lifestyles. [ABSTRACT FROM AUTHOR]

Background: Burnout syndrome (BS) has a negative impact among health professionals. Aims: Our research objective is to quantify the level of burnout in health workers of the Spanish National Health System during the COVID-19 pandemic using and comparing two independent measurement instruments. Methods: Cross-sectional, descriptive and multicenter study conducted through an anonymous online survey among health workers of the National Health System, measuring the level of burnout using the Maslach Burnout Inventory (MBI) and the Copenhagen Burnout Inventory (CBI). Results: A total of 448 questionnaires were analyzed, the mean age of the participants was 43.53 years (range: 20–64), 365 (81.5%) women. 161 (35.9%) participants presented BS measured with the MBI and 304 (67.9%) measured with the CBI. Regarding work contract, those who had greater job stability presented a higher degree of cynicism with respect to the eventual ones (p =.010), the eventual ones presenting higher mean scores in professional efficacy (p =.034). Urban workers had higher scores of exhaustion (p <.001) and cynicism (p <.001) than those living in rural areas. When comparing both tests, a high predictive value for exhaustion and cynicism was found to measure BS through the CBI (AUC = 0.92 and 0.84, respectively) and a low AUC with respect to the predictive value for efficacy (AUC = 0, 59). Conclusions: The results obtained show a high level of BS among the health workers who participated in our study. Both tests have an excellent correlation in the degree of exhaustion and cynicism, but not in efficacy. The BS measurement must be performed with at least two validated instruments to increase its reliability. [ABSTRACT FROM AUTHOR]

One of the research issues considered in landscape ecology is the fragmentation of landscapes, which is characterised by a great heterogeneity of land uses and shapes. The objective of this study was to investigate changes in landscape fragmentation and connectivity associated with the afforestation on agricultural land in two locations in southern Spain that was promoted by an EU scheme between 1990 and 2018. This was done using the Andalusia Land Cover Databases (1990 and 2018), along with the combination of two approaches with which to determinate the variation of fragmentation (Patch Analyst-ARCgis and LDTtool) and ecosystem connectivity (Graphab software). Afforestation on agricultural land represented significant change in land use in the two locations (Andevalo, Quercus ilex and Q. suber, 22,313.25 ha) and Guadix (Pinus halepensis, 2532.68 ha). Changes in fragmentation metrics reflected that landscape fragmentation increased as a consequence of afforestation, and a significate decrease in mean patch size (MPS) and mean patch edge (MPE) was observed over time in both locations in most land uses. Furthermore, afforestation increased connectivity for forest species, which was reflected in higher values of connectivity metrics (probability of connectivity and flux). The presence of low-cost pathways connecting patches suggested a reduction in the gap-crossing distance between forests, although the increase on fragmentation of forest patches there where an increase in forest connectivity that revealed favourable relationship between afforestation and landscape connectivity functions. The European Community policies aimed at the afforestation of marginal agricultural land could, therefore, play an important role in improving the ecological functions of agricultural landscapes. [ABSTRACT FROM AUTHOR]

Background: Most patients diagnosed with heart failure (HF) are older adults with multiple comorbidities. Multipathological patients constitute a population with common characteristics: greater clinical complexity and vulnerability, frailty, mortality, functional deterioration, polypharmacy, and poorer health-related quality of life with more dependency. Objectives: To evaluate the clinical characteristics of hospitalized patients with acute heart failure and to determine the prognosis of patients with acute heart failure according to the Short Physical Performance Battery (SPPB) scale. Methods: Observational, prospective, and multicenter cohort study conducted from September 2020 to May 2022 in patients with acute heart failure as the main diagnosis and NT-ProBNP > 300 pg. The cohort included patients admitted to internal medicine departments in 18 hospitals in Spain. Epidemiological variables, comorbidities, cardiovascular risk factors, cardiovascular history, analytical parameters, and treatment during admission and discharge of the patients were collected. Level of frailty was assessed by the SPPB scale, and dependence, through the Barthel index. A descriptive analysis of all the variables was carried out, expressed as frequencies and percentages. A bivariate analysis of the SPPB was performed based on the score obtained (SPPB ≤ 5 and SPPB > 5). For the overall analysis of mortality, HF mortality, and readmission of patients at 30 days, 6 months, and 1 year, Kaplan–Meier survival curves were used, in which the survival experience among patients with an SPPB > 5 and SPPB ≤ 5 was compared. Results: A total of 482 patients were divided into two groups according to the SPPB with a cut-off point of an SPPB < 5. In the sample, 349 patients (77.7%) had an SPPB ≤ 5 and 100 patients (22.30%) had an SPPB > 5. Females (61%) predominated in the group with an SPPB ≤ 5 and males (61%) in those with an SPPB > 5. The mean age was higher in patients with an SPPB ≤ 5 (85.63 years). Anemia was more frequent in patients with an SPPB ≤ 5 (39.5%) than in patients with an SPPB ≥ 5 (29%). This was also seen with osteoarthritis (32.7%, p = 0.000), diabetes (49.6%, p = 0.001), and dyslipidemia (69.6%, p = 0.011). Patients with an SPPB score > 5 had a Barthel index < 60 in only 4% (n = 4) of cases; the remainder of the patients (96%, n = 96) had a Barthel index > 60. Patients with an SPPB > 5 showed a higher probability of survival at 30 days (p = 0.029), 6 months (p = 0.031), and 1 year (p = 0.007) with (OR = 7.07; 95%CI (1.60–29.80); OR: 3.9; 95%CI (1.30–11.60); OR: 6.01; 95%CI (1.90–18.30)), respectively. No statistically significant differences were obtained in the probability of readmission at 30 days, 6 months, and 1 year (p > 0.05). Conclusions: Patients admitted with acute heart failure showed a high frequency of frailty as assessed by the SPPB. Patients with an SPPB ≤ 5 had greater comorbidities and greater functional limitations than patients with an SPPB > 5. Patients with heart failure and a Barthel index > 60 frequently presented an SPPB < 5. In daily clinical practice, priority should be given to performing the SPPB in patients with a Barthel index > 60 to assess frailty. Patients with an SPPB ≤ 5 had a higher risk of mortality at 30 days, 6 months, and 1 year than patients with an SPPB ≤ 5. The SPPB is a valid tool for identifying frailty in acute heart failure patients and predicting 30-day, 6-month, and 1-year mortality. [ABSTRACT FROM AUTHOR]

This research aims to analyze the persuasiveness of bookfluencers and the impact of content formats on their followers' engagement and intention to purchase books. The theoretical framework for this study is the Elaboration Probability Model adapted to social networks. The research used the Experimental Vignette Methodology through a questionnaire launched to YouTube, Instagram, and TikTok users and via email to UEMC (Miguel de Cervantes European University) students. The data collected were treated statistically. The findings confirm the importance of argument quality in persuasive messages. The results highlight the significance of the audiovisual content format, both in the engagement and purchase intention, when followers process information through their central route. [ABSTRACT FROM AUTHOR]

Introduction: The prognosis of relapsed B cell precursor acute lymphoblastic leukemia (B‐ALL) is poor and few patients can be successfully rescued with conventional therapies. Inotuzumab ozogamicin (IO), an antibody against the CD22 antigen linked to calicheamicin, has been approved as a rescue treatment in relapsed/refractory (R/R) B‐ALL. Patients and Methods: This was an observational, retrospective, multicenter study of adult patients included in the Spanish program of compassionate use of IO in centers from the PETHEMA group (Programa Español de Tratamientos en Hematología). Results: Thirty‐four patients with a median age of 43 years (range, 19–73) were included. Twenty patients (59%) were refractory to the last treatment, IO treatment was given as ≥3rd salvage treatment in 25 patients (73%) and 20 patients (59%) received allogeneic hematopoietic stem cell transplantation before IO treatment. After a median of 2 cycles of IO, 64% of patients achieved complete response (CR)/complete response with incomplete recovery. The median response duration, progression‐free survival and overall survival (OS) were 4.7 (95%CI, 2.4–7.0 months), 3.5 (95%CI, 1.0–5.0 months) and 4 months (95%CI, 1.9–6.1 months) respectively, with better OS for patients with relapsed B‐ALL versus refractory disease (10.4 vs. 2.5 months, respectively) (p =.01). There was a trend for better OS for patients with first CR duration >12 months (7.2 months [95%CI, 3.2–11.2] vs. 3 months [95% CI, 1.8–4.2] respectively) (p =.054). There was no sinusoidal obstruction syndrome (SOS) event during IO treatment, but three patients (9%) developed grade 3–4 SOS during alloHSCT after IO treatment. Conclusions: Our study showed slightly inferior outcomes of the pivotal trial probably due to poorer risk factors and late onset of IO therapy of recruited patients. Our results support early use of IO in relapsed/refractory ALL patients. [ABSTRACT FROM AUTHOR]

(1) Background: COVID-19 has evolved during seven epidemic waves in Spain. Our objective was to describe changes in mortality and severity in our hospitalized patients. (2) Method: This study employed a descriptive, retrospective approach for COVID-19 patients admitted to the Hospital de Fuenlabrada (Madrid, Spain) until 31 December 2022. (3) Results: A total of 5510 admissions for COVID-19 were recorded. The first wave accounted for 1823 (33%) admissions and exhibited the highest proportion of severe patients: 65% with bilateral pneumonia and 83% with oxygen saturation under 94% during admission and elevated levels of CRP, IL-6, and D-dimer. In contrast, the seventh wave had the highest median age (79 years) and comorbidity (Charlson: 2.7), while only 3% of patients had bilateral pneumonia and 3% required intubation. The overall mortality rate was 10.3%. The first wave represented 39% of the total. The variables related to mortality were age (OR: 1.08, 1.07–1.09), cancer (OR: 1.99, 1.53–2.60), dementia (OR: 1.82, 1.20–2.75), the Charlson index (1.38, 1.31–1.47), the need for high-flow oxygen (OR: 6.10, 4.94–7.52), mechanical ventilation (OR: 11.554, 6.996–19.080), and CRP (OR: 1.04, 1.03–1.06). (4) Conclusions: The variables associated with mortality included age, comorbidity, respiratory failure, and inflammation. Differences in the baseline characteristics of admitted patients explained the differences in mortality in each wave. Differences observed between patients admitted in the latest wave and the earlier ones suggest that COVID-19 has evolved into a distinct disease, requiring a distinct approach. [ABSTRACT FROM AUTHOR]

Introduction: Here we report the results obtained in an innovative teaching experience that encourages the development of Critical Thinking skills through motivational intervention. Understanding Critical Thinking as a theory of action, "we think to solve problems", and accompanying this concept with a program aimed at teaching/learning Critical Thinking and with active methodologies such as "Problem-Based Learning" (PBL), we developed a parallel program designed to foster motivation for the development of these skills. This motivational instruction is based on a theoretical option that understands motivation as the result of two variables: "Expectancy/Value." These two concepts enable an intervention in motivation towards more efficient Critical Thinking. Method: 89 Spanish university students of both sexes were enrolled in the study, with ages between 20 and 30 years, who were assessed by means of the PENCRISAL and the AGQ at both the start and the end of the intervention, together with continuous assessment. During the intervention, all the students received instruction in Critical Thinking. However, only half of the sample also participated in the motivation program. Results: The results show that instruction in Critical Thinking skills through ARDESOS was successful. Moreover, the results obtained concerning motivation pointed to a maintenance of the scores in the group subjected to the motivation program. Discussion: The results of the present study show that to a large extent intervention in motivation functions well. Nevertheless, it is necessary to increase such improvements. Thus, we describe a tool for studying the motivational factors of Critical Thinking, which could be especially useful from the perspective of instruction and pedagogical research.

Simple Summary: To our knowledge, this is the first study to use free text from electronic healthcare records as a data source extracted with natural language processing to characterize the clinical characteristics and management of patients with chronic lymphocytic leukemia. A total of 534 included patients were stratified regarding the type of therapeutic management during the study period. Our results highlight the increased use of drugs directed to specific target therapies and the lower frequency of treatment with chemoimmunotherapy both in the first line and in relapsed/refractory settings in our sample of seven academic hospitals from 2016 to 2018. This real-world evidence study provides information on the diversity of clinical features and treatment patterns of chronic lymphocytic leukemia, evidencing the need to optimize patients' clinical management through personalizing their therapeutic approach. The SRealCLL study aimed to obtain real-world evidence on the clinical characteristics and treatment patterns of patients with chronic lymphocytic leukemia (CLL) using natural language processing (NLP). Electronic health records (EHRs) from seven Spanish hospitals (January 2016–December 2018) were analyzed using EHRead® technology, based on NLP and machine learning. A total of 534 CLL patients were assessed. No treatment was detected in 270 (50.6%) patients (watch-and-wait, W&W). First-line (1L) treatment was identified in 230 (43.1%) patients and relapsed/refractory (2L) treatment was identified in 58 (10.9%). The median age ranged from 71 to 75 years, with a uniform male predominance (54.8–63.8%). The main comorbidities included hypertension (W&W: 35.6%; 1L: 38.3%; 2L: 39.7%), diabetes mellitus (W&W: 24.4%; 1L: 24.3%; 2L: 31%), cardiac arrhythmia (W&W: 16.7%; 1L: 17.8%; 2L: 17.2%), heart failure (W&W 16.3%, 1L 17.4%, 2L 17.2%), and dyslipidemia (W&W: 13.7%; 1L: 18.7%; 2L: 19.0%). The most common antineoplastic treatment was ibrutinib in 1L (64.8%) and 2L (62.1%), followed by bendamustine + rituximab (12.6%), obinutuzumab + chlorambucil (5.2%), rituximab + chlorambucil (4.8%), and idelalisib + rituximab (3.9%) in 1L and venetoclax (15.5%), idelalisib + rituximab (6.9%), bendamustine + rituximab (3.5%), and venetoclax + rituximab (3.5%) in 2L. This study expands the information available on patients with CLL in Spain, describing the diversity in patient characteristics and therapeutic approaches in clinical practice. [ABSTRACT FROM AUTHOR]

The development of critical thinking in higher education is fundamental, preparing students to think well, find explanations, make decisions and solve problems. Given the importance of its promotion, its assessment is crucial, since the two are inseparable. Moreover, the number of instruments that are validated to assess critical thinking in the Portuguese language and culture are scarce. We present the validation psychometric study of the PENCRISAL test (short version) to the Portuguese language, a critical thinking assessment test for higher education students, designed and validated in Spain (full and short version), which presents adequate reliability and validity psychometric characteristics to assess keydimensions of critical thinking. A sample of 225 Portuguese higher education students from three universities (two public and one private) performed a reduced version of the PANCRISAL test. The results obtained allowed replicating the Spanish reduced version in Portugal (only changing one of the six items), and the confirmatory factorial analysis permits to identify two factors intercorrelated, legitimizing the combination of the six items in a global score. This short version can be used as a screening test, and its potential is pointed out to assess students critical thinking to support teaching and research in higher education. [ABSTRACT FROM AUTHOR]