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This research investigated the level of knowledge and perceptions of trainee teachers towards the LGBTQ+ community. In order to achieve this, a descriptive study was carried out, with the objective of becoming aware of the expectations and preconceptions held by trainee teachers in the fourth year of their degree course in Primary and Infant Education during the 2018-2019 session. In addition, limitations of the educational approach and the keys to awareness and acceptance in school, of sexual and gender diversity, were also investigated. In order to collect the data a questionnaire instrument was used and a discussion group was also identified. The key results revealed that trainee teachers do understand the reality of this community and are disposed in favour of the acceptance of sexual and gender diversity in the classroom. In fact, they demonstrated the need for important training in order to provide an effective approach to sexually related material.

The present study relates to a research line in didactics of science that focuses on the function that sign systems or semiotic modes have in communicative interactions in science classrooms. The study was conducted by 20 secondary and university science teachers who belong to the same research group LIEC ("Language and Science Teaching") at the Universitat Autonoma de Barcelona (UAB). This group is devoted to the study of the relations between language and science teaching, and is centred on the analysis of textbooks, because these are still the most used "didactical mediators" in science teaching. The study attempted to construct indicators in order to investigate whether textbooks are adequate for didactical intervention. Such an investigation would provide useful information for better strategies both to read in class and to write more innovative textbooks from a "didactical" point of view, i.e., textbooks that are more appropriate to support students' autonomous work in science classrooms. (Contains 1 figure and 2 tables.)

Currently, there is a wide diversity of project-based learning instructional designs presented as "STEAM projects". However, it is essential to evaluate if all these STEAM projects align their learning objectives and activities with the intended STEAM competences. This paper aims to characterize the impact of the STEAM educational approach through the analysis of contemporary STEAM projects implemented in five Spanish secondary schools from a curricular perspective based on STEM practices. A dataset comprising 46 secondary school STEAM projects implemented in Spain was evaluated using STEM project-based learningrubric, considering 21 evaluation criteria. The findings reveal an imbalance in the sophistication of STEAM projects concerning Science and Technology disciplinary-linked criteria and meta-disciplinary-linked criteria within this framework. These results enable the mapping and highlighting of the fact that not all STEAM projects equally serve their intended educational purposes or integrate all their features with the same level of sophistication. Curriculum organizations from different secondary school levels are also pointing out notable differences regarding how they address STEM competence. Acknowledging these differences and challenges in further initiatives of STEAM PBL instructional designs could support their design. By identifying areas of improvement, educators can optimize the impact of these projects on fostering STEAM competences among students. [ABSTRACT FROM AUTHOR]

BACKGROUND: Prenatal exposure to endocrine-disrupting chemicals (EDCs) may disrupt normal fetal and postnatal growth. Studies have mainly focused on individual aspects of growth at specific time points using single chemical exposure models. However, humans are exposed to multiple EDCs simultaneously, and growth is a dynamic process. OBJECTIVE: The objective of this study was to evaluate the associations between prenatal exposure to EDCs and children’s body mass index (BMI) growth trajectories using single exposure and mixture modeling approaches. METHODS: Using data from the INfancia y Medio Ambiente (INMA) Spanish birth cohort (푛=1,911), prenatal exposure to persistent chemicals [hexachlorobenzene (HCB), 4-4′-dichlorodiphenyldichloroethylene (DDE), polychlorinated biphenyls (PCB-138, -150, and -180), 4 perfluoroalkyl substances (PFAS)] and nonpersistent chemicals (8 phthalate metabolites, 7 phenols) was assessed using blood and spot urine concentrations. BMI growth trajectories were calculated from birth to 9 years of age using latent class growth analysis. Multinomial regression was used to assess associations for single exposures, and Bayesian weighted quantile sum (BWQS) regression was used to evaluate the EDC mixture's association with child growth trajectories. RESULTS: In single exposure models exposure to HCB, DDE, PCBs, and perfluorononanoic acid (PFNA) were associated with increased risk of belonging to a trajectory of lower birth size followed by accelerated BMI gain by 19%–32%, compared with a trajectory of average birth size and subsequent slower BMI gain [e.g., relative risk ratio (RRR) per doubling in DDE concentration=1.19 (95% CI: 1.05, 1.35); RRR for PFNA=1.32 (95% CI: 1.05, 1.66)]. HCB and DDE exposure were also associated with higher probability of belonging to a trajectory of higher birth size and accelerated BMI gain. Results from the BWQS regression showed the mixture was positively associated with increased odds of belonging to a BMI trajectory of lower birth size and accelerated BMI gain (odds ratio per 1-quantile increase of the mixture=1.70; credible interval: 1.03, 2.61), with HCB, DDE, and PCBs contributing the most. DISCUSSION: This study provides evidence that prenatal EDC exposure, particularly persistent EDCs, may lead to BMI trajectories in childhood characterized by accelerated BMI gain. Given that accelerated growth is linked to a higher disease risk in later life, continued research is important. [ABSTRACT FROM AUTHOR]

The continuing incorporation of immigrant populations into the Spanish educational system poses an important challenge in that all participants must cooperate toward creating the best possible adaptation process at the academic level as well as on the personal and social levels. A number of different factors appear to influence children's adjustment during the preschool stage, and these factors are especially relevant since many studies have shown that this is a key period for the prevention of future difficulties. The present study examines the variables involved in the adaptation of a group of preschool-aged children from different cultural backgrounds in Spain. The results indicate that preschoolers, regardless of their background, have similar performance and learning potential, with language proficiency being the factor that most clearly affects the other variables investigated. It was also found that children's attitudes toward learning were related to the presence of behavioral difficulties and with the quality and type of parental child-rearing practices. These practices appear to be related to a number of difficulties immigrant children may experience on personal and social levels.

The European eel Anguilla anguilla is a critically endangered catadromous species. There is an urgent need for close surveillance of the populations that are still viable in European rivers. The species is difficult to observe in freshwater because of its bottom-dwelling behavior; the currently employed methods of eel monitoring in Europe based on the physical capture of individuals are stressful and may cause mortality. Here, we present a new highly sensitive method based on an A. anguilla-specific qPCR marker designed within the cytochrome oxidase I mitochondrial gene for application on environmental DNA (eDNA). Since the detectability of eDNA depends on the hydrographic conditions, we applied correction for altitude and a linear model and were able to predict the eel biomass from the eDNA in the different rivers of northern Spain still holding wild populations. The method was validated by electrofishing surveys. This novel eDNA-based marker allows for estimating the European eel biomass in running waters from small 1.5 L water samples and could complement, or replace in some cases, current eel surveys without disturbing wild populations. [ABSTRACT FROM AUTHOR]

Augmented reality (AR) provides huge opportunities for online teaching in science and engineering, as these disciplines place emphasis on practical training and unsuited to completely nonclassroom training. This paper proposes a new concept in virtual and remote laboratories: the augmented remote laboratory (ARL). ARL is being tested in the first and second years of the new degrees in industrial engineering and computer engineering, respectively, at the School of Engineering, University of Huelva, Huelva, Spain. By means of augmented reality techniques, ARL allows the student to experience sensations and explore learning experiences that, in some cases, may exceed those offered by traditional laboratory classes. The effectiveness of this methodology for remote laboratory work is evaluated by comparing it to practical sessions in the laboratory at the university itself with the same group of students. Students completed a questionnaire after having experienced both types of practicals, and the results show that the use of ARL improves student outcomes. As discussed in the paper, the potential of AR to configure different experiments from the same physical configuration is virtually limitless. (Contains 1 table and 14 figures.)

This article presents the results of a research project concerned with analysing and identifying the discourses and related strategies used by Spanish-German trans-migrant families to support and develop bilingual and intercultural competences stemming from their transmigratory experiences. Using the biographical-narrative approach, we reconstruct the families' migratory phases, emphasising shifting parental discourses on bilingual practices and intercultural competences in the home. After presenting the analysed empirical data, the results obtained are grouped into four broader intrepretative frameworks: bilingual practice, life-world intercultural theories, social networks and "cosmopolitanism". (Contains 3 notes.)

This article presents the results of an exploratory empirical study into the perception of conventionally indirect requests in British English and Peninsular Spanish, given the high incidence of the pragmatic category over others in its encoding of politeness in both related and unrelated languages (cf. Blum-Kulka et al., 1989). More specifically, the article focuses on the similarities and differences between Britons and Spaniards with regard to the speaker's assumed expectations of compliance in choosing from the conventionally indirect spectrum. In other words, the focus is on how (un)certain the speaker was that the addressee would comply with the request when s/he chose a particular conventionally indirect request. The data for this study were collected via an open role play, post-performance interviews and questionnaires. The results obtained show that, in comparable situations, the Spaniards were generally more certain that the addressee would comply with the request than the Britons. It is argued that conventional indirectness appears to reflect different social meanings in English and Spanish and that such differences should be taken into account when analysing the realization patterns of pragmatic categories in language.

This article describes the adaptation of a non-spatial model of pastureland dynamics, including vegetation life cycle, livestock management and nitrogen cycle, for use in a spatially explicit and modular modelling platform (k.LAB) dedicated to make data and models more interoperable. The aim is to showcase to the social-ecological modelling community the delivery of an existing, monolithic model, into a more modular, transparent and accessible approach to potential end users, regional managers, farmers and other stakeholders. This also allows better usability and adaptability of the model beyond its originally intended geographical scope (the Cantabrian Region in the North of Spain). The original code base (written in R in 1,491 lines of code divided into 13 files) combines several algorithms drawn from the literature in an opaque fashion due to lack of modularity, non-semantic variable naming and implicit assumptions. The spatiotemporal rewrite is structured around a set of 10 namespaces called PaL (Pasture and Livestock), which includes 198 interoperable and independent models. The end user chooses the spatial and temporal context of the analysis through an intuitive web-based user interface called k.Explorer. Each model can be called individually or in conjunction with the others, by querying any PaL-related concepts in a search bar. A scientific dataflow and a provenance diagram are produced in conjunction with the model results for full transparency. We argue that this work demonstrates key steps needed to create more Findable, Accessible, Interoperable and Reusable (FAIR) models beyond the selected example. This is particularly essential in environments as complex as agricultural systems, where multidisciplinary knowledge needs to be integrated across diverse spatial and temporal scales in order to understand complex and changing problems. [ABSTRACT FROM AUTHOR]

The dual theory establishes that the decision-making process relies on two different systems, the affective system and the executive function (EF), developed during adolescence. This study analyzes the relationship between the decision-making and EF processes in a group of early adolescents (mean age = 12.51 years, SD = 0.61), where more affective impulse processes are developed, and in young adults (mean age = 19.38 years, SD = 1.97), where cognitive control processes have already matured. For this purpose, 140 participants in Spain completed the Iowa Gambling Task (IGT) to measure their risky decisions and the Wisconsin Card Sorting Task (WCST) to measure their EF. Performance on the IGT improves over blocks; however, adolescents received lower mean scores than young adults. However, controlling for age, perseverative errors were negatively associated with the mean net score on the risky blocks of IGT; thus, those who committed more perseverative errors in the WCST were more likely to take cards from the disadvantageous decks on the last blocks of the IGT. The current study shows that adolescents and adults solve ambiguous decisions by trial and error; however, adolescents are more likely to make risky decisions without attending to the long-term consequences. Following the dual theory hypothesis, the maturation of EF with age partly accounts for this difference in risky decision-making between adolescents and adults. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the safety, feasibility, and preliminary effectiveness of implementing supervised exercise programming into the clinical care of individuals with advanced cancer. Design: Single group implementation feasibility study using a pre–posttest design. Setting: Exercise Oncology Unit of the Spanish Cancer Association (a cancer-specific community facility outside the hospital setting). Participants: Adult individuals with advanced cancer profile involving advanced local cancer or distant metastases. Intervention: A 12-week, twice-weekly, supervised, clinic-based multi-component exercise program. Main Measure: Paired t -tests were used to assess pre–post changes and analyses of covariance were used to compare effects based on selected participant characteristics. Results: Eighty-four individuals with advanced cancer completed the baseline assessment, with six participants withdrawing prior to the start of the program. Of the 78 participants, 17 dropped out, thus, a total of 61 completed the final assessment. Mean adherence was 82.5%. No serious adverse events occurred. Exercise significantly improved VO2max by 5.2 mL·kg·min (p < 0.001), chest strength (p < 0.001), leg strength (p < 0.001), lean body mass (p = 0.003), skeletal muscle mass (p < 0.002), % body fat (p = 0.02), quality of life by 5.3 points (p = 0.009), fatigue by 3.2 points (p = 0.012), and physical activity by 1680 METs/week (p < 0.001). Conclusions: Our clinically supervised and tailored exercise program involving moderate to vigorous intensity exercise was found to be feasible, safe, and effective for individuals with advanced cancer. Implications for Cancer Survivors: With proper screening and supervision, individuals with advanced cancer can benefit from tailored exercise oncology support as part of an overall therapeutic care plan. [ABSTRACT FROM AUTHOR]

Through an interpersonal global writing exchange between middle school students in Spain and the United States, students develop skills in world languages, cultural awareness, sensitivity, and communication. [ABSTRACT FROM AUTHOR]

Background and objectives: Glycerol phenylbutyrate (GPB) has demonstrated safety and efficacy in patients with urea cycle disorders (UCDs) by means of its clinical trial program, but there are limited data in clinical practice. In order to analyze the efficacy and safety of GPB in clinical practice, here we present a national Spanish experience after direct switching from another nitrogen scavenger to GPB. Methods: This observational, retrospective, multicenter study was performed in 48 UCD patients (age 11.7 ± 8.2 years) switching to GPB in 13 centers from nine Spanish regions. Clinical, biochemical, and nutritional data were collected at three different times: prior to GPB introduction, at first follow-up assessment, and after one year of GPB treatment. Number of related adverse effects and hyperammonemic crisis 12 months before and after GPB introduction were recorded. Results: GPB was administered at a 247.8 ± 102.1 mg/kg/day dose, compared to 262.6 ± 126.1 mg/kg/day of previous scavenger (46/48 Na-phenylbutyrate). At first follow-up (79 ± 59 days), a statistically significant reduction in ammonia (from 40.2 ± 17.3 to 32.6 ± 13.9 μmol/L, p < 0.001) and glutamine levels (from 791.4 ± 289.8 to 648.6 ± 247.41 μmol/L, p < 0.001) was observed. After one year of GPB treatment (411 ± 92 days), we observed an improved metabolic control (maintenance of ammonia and glutamine reduction, with improved branched chain amino acids profile), and a reduction in hyperammonemic crisis rate (from 0.3 ± 0.7 to less than 0.1 ± 0.3 crisis/patients/year, p = 0.02) and related adverse effects (RAE, from 0.5 to less than 0.1 RAEs/patients/year p < 0.001). Conclusions: This study demonstrates the safety of direct switching from other nitrogen scavengers to GPB in clinical practice, which improves efficacy, metabolic control, and RAE compared to previous treatments. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to describe the ophthalmologic manifestations found in patients with autism spectrum disorder (ASD) and to assess their prevalence in the different types of ASD. Materials and Methods: This prospective observational study included 344 patients with ASD seen over a period of 8.5 years. They were classified into four subgroups (autism, Asperger syndrome, pervasive developmental disorders not otherwise specified [PDD-NOS], and other). Data obtained from ophthalmological examinations were compared between the groups. Statistical analysis was performed with chi-square, Kruskal-Wallis, and Mann-Whitney tests. Results: Refractive defects were detected in 48.4% of the patients, with the most prevalent being hyperopia and astigmatism. There was a higher prevalence of myopia in Asperger syndrome. Evaluation of extraocular motility revealed the presence of strabismus in 15.4% of patients, with a statistically significantly higher prevalence in autism and the "other" disorders group. The most frequent type of strabismus was exotropia. Convergence was found to be normal in 43.6% of the patients. Nystagmus was observed in only 0.9% of patients. In the binocular sensory tests performed, patients with Asperger syndrome had significantly better results compared to the other groups. Optic nerve abnormalities were found in 4% of patients, with significantly higher prevalence in the "other" disorders group. Conclusion: Ophthalmologic manifestations occur more frequently in patients with ASD than in the general child population. Of these, the most frequent are refractive defects and ocular motility disorder. Therefore, we consider it necessary to perform an ophthalmological evaluation in patients with ASDs. [ABSTRACT FROM AUTHOR]

Domesticated plants can occasionally naturalize, becoming feral elements of natural communities. This is only possible if crops overcome the abiotic and biotic barriers that restrict their dispersal and recruitment. The naturalization of almond trees (Prunus dulcis, (Mill.) D.A. Webb) was recently reported in SE Spain, but the mechanisms driving it remain to be established. In this study, we begin to elucidate how almonds overcome dispersal and initial establishment limitations, the first steps in feralization. We characterized seed removal and demographic structure in feral Prunus dulcis populations. Additionally, we investigated whether seed burial facilitated germination of almonds under greenhouse conditions. Our results indicate that dispersal by rodents (Apodemus and Rattus) might be an important mechanism favouring almond naturalization in SE Spain. Germination experiments showed that seed burial promotes germination and seedling emergence, suggesting that seed caching might play a beneficial role in recruitment. Lastly, our demographic surveys revealed that recruitment does not seem to be influenced by proximity to the maternal plant. We propose that rodents have a synzoochorous relationship with almonds, promoting their feralization and facilitating their establishment in natural communities. [ABSTRACT FROM AUTHOR]

Featured Application: 3D printing. The circular economy model offers great opportunities to companies, as it not only allows them to capture additional value from their products and materials, but also reduce the fluctuations of price-related risks and material supply. These risks are present in all kind of businesses not based on the circular economy. The circular economy also enables economic growth without the need for more resources. This is because each unit has a higher value as a result of recycling and reuse of products and materials after use. Following this circular economics framework, the Polytechnic University of Madrid (Universidad Politécnica de Madrid, UPM) has adopted strategies aimed at improving the circularity of products. In particular, this article provides the result of obtaining recycled PLA filament from waste originating from university 3D FFF (fused filament fabrication) printers and waste generated by "Coronamakers" in the production of visors and parts for PPEs (Personal Protective Equipment) during the lockdown period of COVID-19 in Spain. This filament is used in the production of 3D printed parts that university students use in their classes, so the circular loop is closed. The obtained score of Material Circularity Indicator (MCI) of this material has been calculated, indicating its high level of circularity. [ABSTRACT FROM AUTHOR]

An incomplete skull of a marine reptile with an atypical elongation of the postorbital region is described. The find comes from the Muschelkalk facies (Cañete Formation) of the Villora section (Iberian Range, Cuenca Province, Spain), characterised by a shallow marine (intertidal) environment and dated as Ladinian in age. The small skull has a rectangular shape, lacking, as preserved, upper temporal openings and a parietal foramen. The upper temporal openings might be secondarily closed. However, the absence of a parietal foramen and squamosals in the preserved part and the incompleteness of the pterygoids make a posteriorly postponed location of the upper temporal openings also conceivable. Teeth are all broken off but alveolar spaces indicate large and massive maxillary dentition. Micro-CT-data revealed a highly vascularised inner structure of the dorsal skull elements, which might indicate special feeding adaptations. Adding the new find to an existing phylogenetic analysis of Triassic marine reptiles reveals eosauropterygian, especially nothosauroid, affinities. However, morphological differences to nothosauroids justify the erection of a new genus and species for this enigmatic marine reptile. Its atypical morphology, without any extinct or modern analogue, fits well with the continuously increasing diversity of Triassic marine reptiles, exhibiting various specialised feeding strategies urn:lsid:zoobank.org:act:6D75AEC7-A5C5-4844-B71A-8215AB099134 [ABSTRACT FROM AUTHOR]

Purpose - Might a country's economic growth performance differ depending on the evolution of its human capital? This paper aims to consider education as a channel for human capital improvement and then for economic growth. The authors hypothesize the existence of a threshold for education, after which point the characteristics of economic growth change. Design/methodology/approach - To address this question, the authors turn from a linear framework to a nonlinear one by applying smooth transition specifications. Findings - This empirical analysis for Spain points to the existence of nonlinearities in the relationship between education and economic growth at country level, for both secondary and tertiary education. Next, as different patterns emerge in different regions, the authors provide a regional analysis for a number of representative Spanish regions. The results show that both secondary and tertiary education matter for economic growth and that nonlinearities in this relationship should be taken into account. Practical implications - What is learnt from using Smooth Transition Regression models for the education-economic growth link is that the educational level of the population can be understood as a source of nonlinearities in the economic activity of a country (and of a region). Thus, depending on national and regional educational levels, economic growth behaves differently. Originality/value - Although the importance of nonlinearities has been identified, linearity is usually assumed in this field of the literature. This paper calls into question the linearity assumption by using time series techniques for 1971-2013 in Spain, an OECD country, and testing whether the results at country level hold for different regions within Spain as a robustness check. [ABSTRACT FROM AUTHOR]

Highlights • The paper describes a methodology to obtain an Urban Energy Sustainability Index (UESI). • This methodology can evaluate the global energy performance for any city. • UESI works through the measurement of 12 clearly-defined indicators and targets. • UESI is also a tool for designing effective actions towards energy-sustainable cities. • The index has been applied successfully to two Spanish cities (Malaga and Barcelona). Abstract The aim of the paper is to propose a methodology for evaluating the energy sustainability of a city based on the characterization of the energy end-use, energy systems and flows, as well as other intrinsically related concepts, such as the quality of air and the energy efficiency in transport and buildings. As a result, an Urban Energy Sustainability Index (UESI) has been proposed to measure the energy sustainability of the cities. Several indicators have been proposed to be used to build the index. These indicators have been grouped into three types depending on their influence on energy urban sustainability: basic, instrumental and complementary. For each indicator, an analysis has been done and as a result an expression for estimating it has been proposed. The value of the index is obtained from the combination of these indicators using the weighted average method. The proposed index can be used as an operational tool to improve the sustainability of cities. It also aims to have an international application as it is related to the global sustainability objectives defined by internationally recognized organizations. The proposed methodology has been used for two different Spanish cities, Barcelona and Malaga. The results show that it covers most of the issues related to the use of energy and sustainability in the cities and that it can also be applied to others cities. [ABSTRACT FROM AUTHOR]

In April 2015, the Spanish National Health System (SNHS) developed a national strategic plan for the diagnosis, treatment, and management of hepatitis C virus (HCV). Our aim was to analyze the impact of this on human immunodeficiency virus (HIV)-infected patients included in the HERACLES cohort during the first 6 months of its implementation. The HERACLES cohort (NCT02511496) was set up in March 2015 to evaluate the status and follow-up of chronic HCV infection in patients co-infected with HIV in the south of Spain. In September 2015, the data were analyzed to identify clinical events (death, liver decompensation, and liver fibrosis progression) and rate of treatment implementation in this population. The study population comprised a total of 3474 HIV/HCV co-infected patients. The distribution according to liver fibrosis stage was: 1152 F0-F1 (33.2 %); 513 F2 (14.4 %); 641 F3 (18.2 %); 761 F4 (21.9 %); and 407 whose liver fibrosis was not measured (12.3 %). During follow-up, 248 patients progressed by at least one fibrosis stage [7.1 %; 95 % confidence interval (CI): 6.3-8 %]. Among cirrhotic patients, 52 (6.8 %; 95 % CI: 5.2-8.9 %) developed hepatic decompensation. In the overall population, 50 patients died (1.4 %; 95 % CI: 1.1-1.9 %). Eight hundred and nineteen patients (23.56 %) initiated interferon (IFN)-free treatment during follow-up, of which 47.8 % were cirrhotic. In our study, during 6 months of follow-up, 23.56 % of HIV/HCV co-infected patients included in our cohort received HCV treatment. However, we observed a high incidence of negative short-term outcomes in our population. [ABSTRACT FROM AUTHOR]

Background: The MPOWER strategy encourages suitable monitoring of the tobacco epidemic among health professionals in all countries. Objective: To analyse the prevalence of and attitudes towards tobacco use among Spanish health professionals. Methods: A study was conducted based on an online survey. The study population consisted of health professionals (primary care physicians, specialist physicians and nurses). The questionnaire used included questions about tobacco consumption, knowledge of and attitudes towards smoking. The sample size was calculated according to a database with 9,500 e-mail addresses and listings of health centres and hospitals all over Spain. Statistical analysis was done using the SPSS software programme. Results: The study group comprised a total of 612 health professionals: 322 were women (52.6%), 196 were nurses and 416 were physicians. 11.7% of health professionals were smokers (9.6% regular smokers and 2.1% occasional smokers) and 41.3% were ex-smokers. Within the group of daily smokers, differences were observed between the nurses and the physicians: 11.2 versus 8.9% (p = 0.009). Smoking was recognized as a chronic disorder by 58.2% of health professionals, and 54.6% knew that the most effective intervention to help quit is a combination of psychological and pharmacological treatment. 56% of health professionals always asked their patients about their tobacco consumption. Conclusions: 11.7% of Spanish health professionals are smokers. We found that they have low knowledge about strategies to quit smoking and that there is a low level of therapeutic intervention on smokers. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

In this article, we analyze a service-learning experience developed in a class of the major in Primary Education Teaching at the University of Malaga, in Andalusia, Spain, by resorting to the metaphors produced by pre-service teachers in the narrative and reflective pieces written for classwork. As a result, we unearthed a constellation of metaphors organized into two main axes: (1) metaphors for school success; (2) metaphors for learning and teaching. In our interpretation, the experience makes it possible for the emergence of novel metaphors which resonate with a more dialogical and solidary educational praxis compared to participants' own schooling experiences. • The Service Learning project bridges teacher preparation program and schools. • Metaphors are central to how pre-service teachers make sense of service-learning experience. • Participants' narrative reports encompass both stock metaphors and novel metaphors. • As experience unfolds in narratives, a constellation of novel metaphors emerges and predominate. • Novel metaphors may suggest a novel way to understand the universe that revolves around schooling. [ABSTRACT FROM AUTHOR]

Objectives. The moderator role of guilt on the effect of leisure activities on dementia caregivers’ depressive symptoms was analyzed, considering differences by kinship and guilt as a multidimensional construct. Method. Participants were 351 caregivers (58.97% daughters, 10.54% sons, 19.66% wives, and 10.83% husbands). Measures included frequency of leisure activities, depressive symptoms, and guilt (total scale and 5 factors). Results. A moderator role of guilt was found only for daughters. Specifically, significant interactions between guilt and frequency of leisure activities were found for the total scale and for the Factors 1 (guilt about doing wrong by the care recipient), 2 (guilt about failing to meet the challenges of caregiving), and 3 (guilt about self-care). For those daughters who reported lower levels of leisure activities, showing higher levels of guilt was associated with higher scores in depressive symptoms, whereas those with lower levels of guilt showed lower depressive symptoms scores. Discussion. Feelings of guilt may have different consequences on caregivers’ distress depending on caregivers’ gender and kinship. Daughters with higher levels of guilt who do not engage in leisure activities may be especially vulnerable to suffering psychological distress. [ABSTRACT FROM PUBLISHER]

Periodic calculation of coastal bathymetries can show the evolution of geomorphological features in active areas such as mesotidal estuary mouths. Bathymetries in shallow coastal areas have been addressed mainly by two technologies, lidar and optical remote sensing. Lidar provides good accuracy, but is an expensive technique, requiring planned flights for each region and dates of interest. Optical remote sensing acquires images periodically but its results are limited by water turbidity. Here we use a lidar bathymetry to compare different bathymetry computation methods using a SPOT optical image from a nearby date. Three statistical models (green-band, PCA correlations, and GLM) were applied to obtain mathematical expressions to estimate bathymetry from that image: all gave errors lower than 1 m in an area with depths ranging from 0 to 6 m. These algorithms were then applied to images from three different dates, correcting the effects caused by different tidal and atmospheric conditions. We show how this allows the study of morphological changes. We discuss the accuracy obtained with respect to the reference bathymetry (0.9 m on average, but less than 0.5 m in low-turbidity areas), the effects of the turbidity on our estimations, and compare both with previously published results. The results show that this approach is effective and allows identification of known features of coastal dynamics, and thus it would be an important step towards short-term bathymetry monitoring based on optical satellite remote sensing. [ABSTRACT FROM AUTHOR]

This paper reports a study of the occurrence and levels of polycyclic aromatic hydrocarbons (PAHs) in a bay characterised by a chronic persistent impact. A total of 55 sediment samples were taken at different depths up to 111 m in two sampling campaigns. Chemical analyses were carried out by gas chromatography-mass spectroscopy. The results indicate that: (1) significant spatial variations exist, (2) levels of PAHs are related more strongly to the spatial distribution of sediments than to mineralogy/granulometry, (3) the sediments are slightly-to-moderately contaminated by PAHs, and (4) these PAHs derive from pyrolytic and petrogenic sources. Through use of an innovative data classification system (proposed according to depth and spatial location of sampling points), and using factorial and cluster techniques, five zones have been differentiated depending on the contamination level and source. [ABSTRACT FROM AUTHOR]

Abstract: Previous studies have shown that the external growth records of the posterior adductor muscle scar (PAMS) of the bivalve Pinna nobilis are incomplete and do not produce accurate age estimations. We have developed a new methodology to study age and growth using the inner record of the PAMS, which avoids the necessity of costly in situ shell measurements or isotopic studies. Using the inner record we identified the positions of PAMS previously obscured by nacre and estimated the number of missing records in adult specimens with strong abrasion of the calcite layer in the anterior portion of the shell. The study of the PAMS and inner record of two shells that were 6years old when collected showed that only 2 and 3 PAMS were observed, while 6 inner records could be counted, thus confirming our working methodology. Growth parameters of a P. nobilis population located in Moraira, Spain (western Mediterranean) were estimated with the new methodology and compared to those obtained using PAMS data and in situ measurements. For the comparisons, we applied different models considering the data alternatively as length-at-age (LA) and tag-recapture (TR). Among every method we tested to fit the Von Bertalanffy growth model, we observed that LA data from inner record fitted to the model using non-linear mixed effects and the estimation of missing records using the calcite width was the most appropriate. The equation obtained with this method, L=57.3*(1−e−0.16(t−0.02)), is very similar to that calculated previously from in situ measurements for the same population. [Copyright &y& Elsevier]

This study investigated eff ects of a 9-week intensified aerobic training and 3-weeks of recovery on signs of overload in 9 healthy active young males. Blood and saliva samples were collected and psychological questionnaires were administered during baseline (T1), intermediate load (T2), maximal load (T3), and recovery (T4) periods. Maximal oxygen uptake increased and blood lactate concentration decreased in T3, while running time in a 3 000 m track field test was significantly shorter. No significant changes were found in hematocrit, haemoglobin concentration, white blood cell count, lactate dehydrogenase, transaminases, interleukin-6, tumour necrosis factor- ? , myeloperoxidase and markers of oxidative stress in plasma, or salivary cortisol and testosterone. Increases in diff erent negative aff ect scales and in the total mood disturbance score of the Profi le of Mood States were observed during T3. Scores in the stress scales of the Recovery- Stress Questionnaire for Athletes and in the State Anxiety Scale of the State-Trait Anxiety Inventory also showed significant increases during T3. The lack of effects in biomarkers together with the changes observed in psychological assessment indicates that an intensified training can produce psychological disturbances prone to early overreaching development. Additionally, it seems that psychological parameters are sensitive markers to detect stress produced by load increases. [ABSTRACT FROM AUTHOR]

Background: Despite medical advances, mortality in infective endocarditis (IE) is still very high. Previous studies on prognosis in IE have observed conflicting results. The aim of this study was to identify predictors of in-hospital mortality in a large multicenter cohort of left-sided IE. Methods: An observational multicenter study was conducted from January 1984 to December 2006 in seven hospitals in Andalusia, Spain. Seven hundred and five left-side IE patients were included. The main outcome measure was in-hospital mortality. Several prognostic factors were analysed by univariate tests and then by multilogistic regression model. Results: The overall mortality was 29.5% (25.5% from 1984 to 1995 and 31.9% from 1996 to 2006; Odds Ratio 1.25; 95% Confidence Interval: 0.97-1.60; p = 0.07). In univariate analysis, age, comorbidity, especially chronic liver disease, prosthetic valve, virulent microorganism such as Staphylococcus aureus, Streptococcus agalactiae and fungi, and complications (septic shock, severe heart failure, renal insufficiency, neurologic manifestations and perivalvular extension) were related with higher mortality. Independent factors for mortality in multivariate analysis were: Charlson comorbidity score (OR: 1.2; 95% CI: 1.1-1.3), prosthetic endocarditis (OR: 1.9; CI: 1.2-3.1), Staphylococcus aureus aetiology (OR: 2.1; CI: 1.3-3.5), severe heart failure (OR: 5.4; CI: 3.3-8.8), neurologic manifestations (OR: 1.9; CI: 1.2-2.9), septic shock (OR: 4.2; CI: 2.3-7.7), perivalvular extension (OR: 2.4; CI: 1.3-4.5) and acute renal failure (OR: 1.69; CI: 1.0-2.6). Conversely, Streptococcus viridans group etiology (OR: 0.4; CI: 0.2-0.7) and surgical treatment (OR: 0.5; CI: 0.3-0.8) were protective factors. Conclusions: Several characteristics of left-sided endocarditis enable selection of a patient group at higher risk of mortality. This group may benefit from more specialised attention in referral centers and should help to identify those patients who might benefit from more aggressive diagnostic and/or therapeutic procedures. [ABSTRACT FROM AUTHOR]

Abstract: We present new anatomical information showing that Koutalisaurus kohlerorum, from the Maastrichtian of Lleida Province, northeastern Spain, is most probably the junior synonym of Pararhabdodon isonensis from the same region. Dentary and maxillary characters previously considered as autapomorphies of K. kohlerorum and P. isonensis, respectively, are shown to be synapomorphies uniting the latter with Tsintaosaurus spinorhinus from the Campanian of the Wangshi Group, Shandong Province, China. This study provided conclusive evidence of the presence of the Lambeosaurinae in Europe. Tsintaosaurus spinorhinus and Pararhabdodon isonensis were inferred to form a clade of basal lambeosaurines characterized by a maxilla with an elevated articular facet for the jugal (continuous with the ectopterygoid ridge) and an extremely medially projected symphyseal region of the dentary. This clade originated in Asia during the middle or late Campanian. Pararhabdodon isonensis or its ancestors migrated from Asia to the Iberian island of the European archipelago. Reconstruction of ancestral areas by Fitch parsimony attributes the European occurrence of P. isonensis to a single dispersal event from Asia no later than middle to late Campanian. [Copyright &y& Elsevier]

This article presents a study which described the isolation and characterization of a ranavirus responsible for a systemic hemorrhagic disease in tadpoles of the common midwife toad Alytes obstetricians (CMT). It focuses on the virus that caused a mortality rate among tadpoles in the Picas de Europa National Park in Spain. The study shows the molecular characterization of the virus, including sequence analysis of the DNA polymerase and major capsid protein genes. A systemic distribution of the virus in diseased tadpoles is demonstrated, indicating that the isolated virus was the primary pathogen.

Neuropsychological evaluations conducted in the United States and abroad commonly include the use of tests translated from English to Spanish. The use of translated naming tests for evaluating predominately Spanish-speakers has recently been challenged on the grounds that translating test items may compromise a test's construct validity. The Texas Spanish Naming Test (TNT) has been developed in Spanish specifically for use with Spanish-speakers; however, it is unlikely patients from diverse Spanish-speaking geographical regions will perform uniformly on a naming test. The present study evaluated and compared the internal consistency and patterns of item-difficulty and -discrimination for the TNT and two commonly used translated naming tests in three countries (i.e., United States, Colombia, Spain). Two hundred fifty two subjects (136 demented, 116 nondemented) across three countries were administered the TNT, Modified Boston Naming Test-Spanish, and the naming subtest from the CERAD. The TNT demonstrated superior internal consistency to its counterparts, a superior item difficulty pattern than the CERAD naming test, and a superior item discrimination pattern than the MBNT-S across countries. Overall, all three Spanish naming tests differentiated nondemented and moderately demented individuals, but the results suggest the items of the TNT are most appropriate to use with Spanish-speakers. Preliminary normative data for the three tests examined in each country are provided. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to contribute to the analysis of firms' innovative activities from the knowledge-intensive service activities (KISA) point of view and analyse their relation to the firms' competitive performance in the case of a mature industry, the Spanish ceramic tile cluster. Design/methodology/approach - The research is based on a field survey. Through a selection of variables multivariable tests were applied to map the industry from the KISA standpoint and evaluate the impact of certain knowledge intensive service activities on innovation and performance. Findings - Internal and external knowledge-intensive service activities were related to their output in terms of innovation, competitive advantages and economic performance. Research limitations/implications - Further research must consider and segment customers, suppliers, and other firms in the industry as other sources of KIBS. Practical implications - Understanding how firms access and employ the variety of innovation-related KISA available to them in different industries, and at different times, will help policy makers to design targeted policies and programs to actively stimulate innovation across them. For firms, KISA offers a strategic choice in their innovation objectives. Originality/value - The present analysis contribution to KISA validates a mathematical model to simulate the relation between KISA and the competitive advantage of the firm in the case of a mature medium-tech industry. [ABSTRACT FROM AUTHOR]

Objective: To investigate prognostic factors and predictors of Acinetobacter baumannii isolation in ventilator-associated pneumonia (VAP). We specifically analyzed these issues for imipenem-resistant episodes.Design and Setting: All episodes of VAP are prospectively included in a database. Information about risk factors was retrieved retrospectively.Patients: Eighty-one patients exhibiting microbiologically documented VAP: 41 by A. baumannii (26 by imipenem-resistant) and 40 by other pathogens.Measurements and Results: The following variables were noted: underlying diseases, severity of illness, duration of mechanical ventilation and of hospitalization before VAP, prior episode of sepsis, previous antibiotic, corticosteroid use, type of nutrition, renal replacement therapy, reintubation, transportation out of the ICU, micro-organisms involved in VAP, concomitant bacteremia, clinical presentation, Sequential Organ Failure Assessment (SOFA) scale on the day of diagnosis, and adequacy of empirical antibiotic therapy. Prior antibiotic use was found to be associated with development of VAP by A. baumannii (OR 14). Prior imipenem exposure was associated with the isolation of imipenem-resistant strains (OR 4). SOFA score on the day of diagnosis was the only predictor of in-hospital mortality (OR 1.22); adequacy of empirical antibiotic therapy was a protective factor (OR 0.067).Conclusions: Our results confirm that prior exposure to antimicrobials is an independent predictor for the development of A. baumannii VAP, the prognosis of which is similar to that of infections caused by other pathogens. This study highlights the importance of initial antibiotic choice in VAP or whatever cause. [ABSTRACT FROM AUTHOR]

In Spain, only two of the 12 recorded species of sandflies, Phlebotomus (Larroussius) ariasi Tonnoir and P. (L.) perniciosus Newstead, are proven vectors of Leishmania infantum Nicolle, the causative agent of endemic leishmaniasis. Studies of the distributions of phlebotomine sandflies are important for evaluating the possible effects of climate warming on any northward or altitudinal range shifts of leishmaniasis or the other diseases they transmit. We describe a recent sandfly survey in Spain, starting in the northern Ebro Valley and continuing southeast into the Levante region of the Mediterranean coast. Sandflies ( P. ariasi only) were found for the first time in the northern province of Alava, in the upper Ebro Valley, where cases of canine leishmaniasis have been described during the last decade. Throughout the provinces sampled, P. ariasi predominated over P. perniciosus in cooler bioclimatic zones, and this statistically significant pattern was more marked than that with higher altitudes. [ABSTRACT FROM AUTHOR]

Focuses on the collection of corpses at Madrid, Spain's National Museum of Anthropology highlighting the history and evolution of anthropology. Details and physical description of the corpses; Religious and scientific practices for preserving the dead; Emphasis on the role of anthropologist, Pedro Gonzalez y Velasco and his museum in the development and direction of Spanish anthropology and in exploring questions of race; Development of the degeneration theory and its implications for anthropology.

Examines whether differences in field-dependence exist between Spanish nonathletes and athletes in individual and team sports. Interaction between type of sport and sex.

Myiasis is the term used to describe infestations, both obligatory and accidental, in vertebrate animals and humans by dipteral larvae. The oral cavity is rarely affected by this infestation and the circumstances which can lead to oral myiasis include persistent mouth opening together with poor hygiene, or facial traumatism. We present a case of oral myiasis by larvae of Lucilia sericata, a species present in the Iberian Peninsula, in a hospitalized patient with surgical problems. [ABSTRACT FROM AUTHOR]

Sport injury is a widely extended morbidity condition. However, epidemiological studies are far from giving a convergent outlook. Moreover, there is a lack of studies comparing relative risks of different groups of sports. The present paper is aimed to carry out a descriptive epidemiological study of sport injuries of athletes from 25 sport modalities in order to identify risk factors as well as to compare epidemiological characteristics according to the different sport groups. A sample of 297 athletes from different sport federations in the region of Madrid (Spain) were assessed using a protocol comprising a section about the sport being practiced and a section about injury incidence. Due to the wide variety of sport modalities, the sample was classified into four groups according to the Blázquez and Hernández Moreno's (1984) sports classification. Results showed no gender but age differences in injury incidence. They also showed differences in terms of injury frequency and severity (elapsed time between the injury and the returning to sport practice) among sport groups, being athletes practicing co-operation-opposition sports those who seemed to be more at risk. There were also differences regarding internal/external causes and when the injury was sustained. The global exposure injury rate (training and competition) rose to 4.1 injuries/1.000 hours. [ABSTRACT FROM AUTHOR]

The article discusses a study which focused on the discovery of Pseudodalatias henarejensis in the Ladinian of Spain. It reveals that the specie belongs to the family Pseudodalatiidae, class chondrichthyes and subclass elasmobranchii. It notes that pseudodalatiids have been known from the tooth-based species, and the specie demonstrates that a cutting-clutching dentition evolved in the family Pseudodalatidiidae. It also states that the dentition of Pseudodalatias allows it to hold and cut its prey, has a neoselachian design, but lacks the triple-layered enameloid microstructure of neoselachian teeth.

Purpose To describe the organisation of the registry and the preliminary results in terms of characteristics of high-risk pancreatic ductal adenocarcinoma (PDAC) families recruited to date and findings of the screening programme. To compare early onset sporadic cases (⩽50 years), sporadic cases (>50 years) and cases with family history of cancer, for PDAC possible risk factors. Methods/patients Families with hereditary cancer syndromes predisposing to PDAC were recruited from two main sources: Spanish hospitals participating in PanGenEU, a pan-European multicentre case–control study, and their genetic counseling unit. Individuals at high-risk of PDAC were enrolled into a screening programme, consisting of Endoscopic ultrasound, computerised tomography, magnetic resonance imaging. Genetic testing of candidate genes was offered according to each patient’s risk. Results Among 577 consecutive PDAC cases, recruited via PanGenEU, 36 (6%) had ⩾2 first-degree relative with PDAC: Familial pancreatic cancer (FPC). So far PanGen-Fam has recruited 42 high-risk PDAC families; 25 (60%) had FPC. Five index cases with cancer were positive for BRCA2 and one for BRCA1 germline mutations. In the second year of prospective PDAC screening, one neuroendocrine tumour and a high-grade dysplasia lesion suspicious of carcinoma were diagnosed among 41 high-risk individuals. Furthermore EUS detected chronic-pancreatitis-like parenchymal changes in 15 patients. Concluding statement The identification and recruitment of PDAC high-risk families into the PanGen-Fam registry provides an opportunity to detect early onset cancer and precursor pancreatic cancer lesions at a potentially curative stage and to increase the knowledge of the natural history of the disease. [ABSTRACT FROM AUTHOR]

The interest in conservation agriculture in Spain is evidenced by practical and institutional aspects. The practical aspect is reflected by the area cultivated under this farming system, 1.28 Mha in perennial crops and 0.57 Mha in arable crops, both for 2013. The period under review was 2009–2013 for arable crops and 2006–2013 for perennial crops. In that period, figures increased 208% for no tillage in arable crops, and 54% for groundcovers in perennial crops. The institutional support is reflected by the financial funding given to conservation agriculture farming practices by some Spanish Regional Governments, primarily through Rural Development Programs, that reached over € 200 million in the 2000–2006 period. The origins of soil conservation practices date back to the 1930s and have evolved in parallel in America and Europe. This parallelism has led to the use of different terminology for similar practices that do not always fall within the scope of conservationist practices. Consistent with the literature, and based on the results of 6 meetings with 144 Spanish experts, this paper aimed at clarifying terms and practices applied under the conditions of Spain, but could be useful for other geographies. This article also proposes definitions to clearly describe the different concepts for experts, advisers, and also for policy makers to accurately allocate funds in the European financial framework 2014–2020. [ABSTRACT FROM AUTHOR]

Introduction: The quality of life of university students acquires special importance because it provides information about their life conditions and especially how they perceive it. Objetive: Evaluate the quality of life of students who are enrolled in health science studies and its relation with the following diverse factors: life and dietetic habits, anthropometric parameters and the influence of distinct variables on their perception. Methods: Transversal study of a sample of 1753 health science degree students of nine Spanish universities with a randomized design and stratified by course and faculty for which we applied an ad hoc questionnaire that considered all study variables. Results: The quality of life (QoL) perceived by the participants had a Median of 75. The factors that were explored about the quality of life correlated significantly with their global perception of it (p<0.001). Three dimensions were established and the impact of each one of them on their global perception of QoL was p<0.001. Men perceived better QoL then women and the students with lower Body Mass Index (BMI).Conclusions: University students are a key population for realizing health promotion and prevention activities therefore it is necessary to develop and provide better infrastructures and educative resources in order to enhance their QoL and to promote healthier habits and life styles with special attention on dietetics habits and theperformance of an adequate physical activity. [ABSTRACT FROM AUTHOR]

Highlights: [•] Study of 13-valent pneumococcal conjugate vaccine (PCV13) versus 7-valent PCV (PCV7). [•] Immune responses to PCVs and meningococcal C conjugate vaccine (MnCCV) assessed. [•] Immune responses to MnCCV were similar when coadministered with PCV7 or PCV13. [•] PCV13 elicited substantial antipneumococcal responses against all 13 serotypes. [•] Safety and tolerability were similar between the PCV7 and PCV13 groups. [Copyright &y& Elsevier]

Background: Parenteral nutrition (PN) is a costly technology used widely to provide nutrition to patients who have an inaccessible or non-functioning intestine. Two all-in-one systems currently being used are customized formulations and three-compartment bags. Objective: To provide a systematic cost comparison of the two all-in-one PN systems: individualized (made from nutrient solutions) versus commercialized (made from three-compartment bag), both prepared in hospital pharmacies. Setting: This study was conducted in three public Spanish hospitals. Method: We conducted a cost-minimization study to analyze prospectively the total cost of PN bags, accounting for all of the processes involved in preparing and delivering PN bags (cost of manpower, nutrition solutions, medical supplies and quality controls) in three different healthcare settings. To compare therapeutic alternatives of equivalent nutritional value, the study was performed for the most frequently employed formulation and similar to commercial preparations. A univariate sensitivity analysis was performed to evaluate the impact of different rates of use of three-compartment PN bag. Results: 157 routine acts of PN bag preparation (65 customized and 92 three-compartment) were observed and timed over 9 days. Total costs of the 157 PN bags were included in the study. Mean costs of customized bags were higher than three-compartment bags, 51.16 ± 5.63 € versus 39.69 ± 3.00 € respectively (p < 0.01). Manpower costs were responsible for the majority of the differences found (70%). The time to complete an adult bag for the hospital compounded system was a mean of 25.9 minutes longer than the three-compartment system. In scenarios using a three-compartment system for 30%, 70% and 90% of PN provision, a cost savings of 4.3%, 10.1% and 12.9% respectively could be achieved. Greatest rates of changing from customized bags (70% and 90%), in a hospital with 1,800 PN bags/year, might reduce the annual budget by 9306 € and 11,964.8 €, respectively. Meanwhile, in a large facility the savings for 8,000 TPN days would be 64,248 € and 82,605 €, respectively. Conclusions: Since seeking cost-reduction of effective treatments is needed, the use of three-compartment bags for standard adult PN could lead to cost savings. Our data should be helpful for health care providers to calculate their own cost of administer. [ABSTRACT FROM AUTHOR]

The article discusses a study on the severity of the Influenza A Hemagglutinin Type 1 and Neuraminidase Type 1 (AH1N1) disease among pregnant women admitted to intensive care units in Spain. The information used by researchers was gathered from the database of the Spanish Society of Intensive Care Medicine. The researchers noted the relationship between pregnancy and primary viral pneumonia.

Purpose The primary objective of this work is to externally validate the Index for Mortality Prediction After Cardiac Transplantation (IMPACT) score in the Spanish cohort. Methods Spanish Heart Transplant Registry data were used to identify isolated adult (>16 years) OHT performed from 2000 to 2015. Individual values of the IMPACT score were calculated for each patient. Overall 1-year mortality after OHT was assessed and 1-year mortality rates between predefined IMPACT score groups (0-2pts, 3-5pts, 6-9ptos, 10-14ptos, ≥15pts) were compared. Correlation between the observed and expected mortality according to the IMPACT score was evaluated. Finally, discrimination ability was assessed by the area under the ROC curve. Results We identified 2,814 OHT. Baseline characteristics are shown in the table. Mean value of the IMPACT score was 6.3±4.9 points. Overall 1-year survival rate was 79.1%. Kaplan-Meier 1-year survival rates by IMPACT score groups were 84.6%, 81.3%, 79.4%, 76.4% and 58.3% respectively (p <0.001). Correlation between the observed mortality in our series and that expected according to the IMPACT score was good (r=0.78), while its discrimination ability was poor (AUC=0.52). Conclusion OHT mortality in Spain is adjusted to that expected by the IMPACT score, so there is good calibration of the predictive model. However, its predictive strength is poor and similar to that determined by chance. On the other hand, there is a lack of studies that evaluate the impact on clinical practice and outcomes of OHT. In the absence of these studies, we cannot implement the IMPACT score in our daily clinical decision making. [ABSTRACT FROM AUTHOR]