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Purpose: Pro-vegetarian (PVG) dietary patterns have shown health benefits, although the evidence concerning their association with mortality is scarce, particularly in older populations. We investigated the effect of three defined PVG patterns on all-cause, cardiovascular disease (CVD) and cancer mortality risk in an older Mediterranean population. Methods: We analysed baseline data from 597 adults aged 65 and older who participated in a population-based cross-sectional study, and mortality during a 12-year period. We used a validated food frequency questionnaire to estimate the adherence in tertiles to three evidence-based PVG dietary patterns: a general PVG pattern (gPVG) and two specific variations (healthful -hPVG, and unhealthful -uPVG). The gPVG pattern incorporated data from 12 food groups, consisting of 7 plant-based and 5 animal-based. The hPVG and uPVG versions included information from 18 food groups (4 food groups added and the splitting of 2 food groups). We used Cox regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) adjusting for relevant covariates. Results: After the 12-years follow-up period, moderate adherence to hPVG pattern was associated with lower all-cause and CVD mortality whereas greater adherence to uPVG pattern was associated with higher all-cause and CVD mortality. Compared with those in the lowest tertile, participants in the second tertile of adherence to the hPVG pattern showed a significant lower risk of all-cause mortality (HR = 0.59; 95%CI: 0.43, 0.82) and CVD mortality (HR = 0.47; 0.28, 0.78). Participants in the highest tertile of adherence to the uPVG showed an increased mortality risk of all-cause (HR = 1.53; 1.07, 2.19) and CVD (HR = 2.10; 1.19, 3.70). No significant associations were found between adherence to any of the PVG dietary patterns and cancer mortality. Conclusion: Moderate adherence to a healthy PVG pattern reduced the long-term mortality risk for all-cause and CVD in an older Mediterranean population, while higher adherence to an unhealthy PVG pattern increased the risk of all-cause and CVD mortality.

New technologies (NT) are increasingly used in Occupational Therapy (OT) interventions in people with Autism Spectrum Disorder (ASD). We conducted a scoping review to describe OT interventions investigated in scientific literature which use NT in children and adolescents with ASD. Two authors independently searched the scientific databases PubMed, EMBASE, Scopus and Web of Science, carried out a peer-review screening of articles and extracted data. Twenty studies met the inclusion criteria. OT interventions lasted between 1 week and 12 months, consisted of between 1 session per day and 5 sessions per week, were carried out exclusively by an occupational therapist, and the most used NT was the computer (n = 12). The duration of the interventions and assessment measures used varied greatly between studies.

In this paper, we show a laboratory experience describing the possibility to build a sensor using a coil to measure small thicknesses of materials with the possibility of measuring temperature simultaneously, with the same built sensor. Its operation is based on the following facts: An electric current (a.c), flows through a coil and a magnetic field appears producing self-induction characterized by an electromotive force induced in the coil when a conductive piece is situated in front of the coil. That permits us to obtain information about the distance between the coil and the conductive piece. When this separation thickness is changing, the magnetic field around the coil changes, because the self-induction coefficient (L) is also changing. Using resistance and impedance measurements (voltage in our case) in the coil, an expression has been obtained for the determination of the thickness of a non-conductive sheet placed between a metallic plate and the coil. Calibration measurements of resistance with temperature have been obtained. The thermodynamic analysis is also presented showing the equation of state of the system between the voltage, temperature, and the thickness of the non-conductive sample. The linear thermal expansion coefficient of the sample is also determined.

Introduction: RET inhibitors with impressive overall response rates are now available for patients with NSCLC, yet the identification of RET fusions remains a difficult challenge. Most guidelines encourage the upfront use of next-generation sequencing (NGS), or alternatively, fluorescence in situ hybridization (FISH) or reverse transcriptase-polymerase chain reaction (RT-PCR) when NGS is not possible or available. Taken together, the suboptimal performance of single-analyte assays to detect RET fusions, although consistent with the notion of encouraging universal NGS, is currently widening some of the clinical practice gaps in the implementation of predictive biomarkers in patients with advanced NSCLC. Methods: This situation prompted us to evaluate several RET assays in a large multicenter cohort of RET fusion–positive NSCLC (n = 38) to obtain real-world data. In addition to RNA-based NGS (the criterion standard method), all positive specimens underwent break-apart RET FISH with two different assays and were also tested by an RT-PCR assay. Results: The most common RET partners were KIF5B (78.9%), followed by CCDC6 (15.8%). The two RET NGS-positive but FISH-negative samples contained a KIF5B(15)-RET(12) fusion. The three RET fusions not identified with RT-PCR were AKAP13(35)-RET(12), KIF5B(24)-RET(9) and KIF5B(24)-RET(11). All three false-negative RT-PCR cases were FISH-positive, exhibited a typical break-apart pattern, and contained a very high number of positive tumor cells with both FISH assays. Signet ring cells, psammoma bodies, and pleomorphic features were frequently observed (in 34.2%, 39.5%, and 39.5% of tumors, respectively). Conclusions: In-depth knowledge of the advantages and disadvantages of the different RET testing methodologies could help clinical and molecular tumor boards implement and maintain sensible algorithms for the rapid and effective detection of RET fusions in patients with NSCLC. The likelihood of RET false-negative results with both FISH and RT-PCR reinforces the need for upfront NGS in patients with NSCLC.

Resumen: Las facultades de medicina son los centros responsables del título de grado que habilita para el ejercicio de la profesión médica, regulada por la normativa europea y nacional. Su número ha pasado de 28 a 50 en los últimos 15 años, decisión que debería depender únicamente de criterios académicos y sanitarios.«Es necesario proporcionar a los futuros médicos la mejor formación científica, profesional y humana posible, para que sean capaces de solucionar los problemas de salud, en un itinerario coordinado y continuado que se inicia con el grado y la formación sanitaria especializada, seguida por un desarrollo profesional continuo» (Declaración de Málaga 2022, Estándares para la educación médica en el grado: pensando en el futuro, avalada por instituciones nacionales e internacionales).Tenemos que seguir trabajando de forma coordinada los responsables universitarios y sanitarios para estabilizar, promocionar y aumentar nuestro profesorado.Afrontamos retos, con deseos de mejorar, gracias a la dedicación de todas las personas que se forman y forman para cuidar la salud de los demás, con nuestro mayor agradecimiento. Abstract: The Schools of Medicine are the responsible centers for the Graduate Degree that qualifies for the practice of the medical profession, regulated by European and national legislation. Their number has increased from 28 to 50 in the last 15 years, a decision that should depend solely on academic and health criteria.“It is necessary to provide future physicians with the best possible scientific, professional and human training, so that they are capable of solving health problems, in a coordinated and continuous itinerary that begins with the degree and specialized health training, followed by continuous professional development” (Declaration of Malaga 2022. Standards for undergraduate medical education: thinking about the future, endorsed by national and international institutions).We need to continue working in a coordinated manner between university and healthcare leaders to stabilize, promote and increase our faculty.We face challenges, with the desire to improve, thanks to the dedication of all the people who are formed and form to care for the health of others, with our greatest gratitude.

Neurodevelopmental disorders (NDDs), of which Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are two of the most common, are described as a group of conditions that begin in the developmental period and lead to deficits that impair functioning [...]

Background: The COVID-19 lockdown represented an immense impact on human health, which was characterized by lifestyle and dietary changes, social distancing and isolation at home. Some evidence suggests that these consequences mainly affected women and altered relevant ongoing clinical trials. The aim of this study was to evaluate the status and changes in diet, physical activity (PA), sleep and self-reported health status (SRH) as perceived by older adult men and women with metabolic syndrome during the COVID-19 lockdown. Methods: We analyzed data from 4681 Spanish adults with metabolic syndrome. We carried out a telephone survey during May and June 2020 to collect information on demographics, dietary habits, PA, sleep, SRH and anthropometric data. Results: The mean age of participants was 64.9 years at recruitment, and 52% of participants were men. Most participants (64.1%) perceived a decrease in their PA during confinement. Regarding gender-specific differences, a higher proportion of women than men perceived a decrease in their PA (67.5% vs. 61.1%), Mediterranean diet adherence (20.9% vs. 16.8%), sleep hours (30.3% vs. 19.1%), sleep quality (31.6% vs. 18.2%) and SRH (25.9% vs. 11.9%) (all p < 0.001). Conclusions: The COVID-19 lockdown affected women more negatively, particularly their self-reported diet, PA, sleep and health status.

In Spain, several local studies have highlighted the likely presence of unknown olive cultivars distinct from the approximately 260 ones previously described in the literature. Furthermore, recent advancements in identification techniques have significantly enhanced in terms of efficacy and precision. This scenario motivated a new nationwide prospecting effort aimed at recovering and characterizing new cultivated germplasm using high-throughput molecular markers. In the present study, the use of 96 EST-SNP markers allowed the identification of a considerable amount of new material (173 new genotypes) coming from areas with low intensification of production in different regions of Spain. As a result, the number of distinct national genotypes documented in the World Olive Germplasm Bank of IFAPA, Córdoba (WOGBC-ESP046) increased to 427. Likewise, 65 and 24 new synonymy and homonymy cases were identified, respectively. This rise in the number of different national cultivars allowed to deepen the knowledge about the underlying genetic structure. The great genetic variability of Spanish germplasm was confirmed, and a new hot spot of diversity was identified in the northern regions of La Rioja and Aragon. Analysis of the genetic structure showed a clear separation between the germplasm of southern and northern-northeastern Spain and indicated a significantly higher level of admixture in the latter. Given the expansion of modern olive cultivation with only a few cultivars, this cryptic germplasm is in great danger of disappearing. This underlines the fact that maintaining as many cultivars as possible will increase the genetic variability of the olive gene pool to meet the future challenges of olive cultivation.

Abstract Cultural projects, particularly when aiming at social impact, are usually the result of the context, values, and social fabric. Some endogenous factors, such as governance models and availability of resources, mainly committed human resources, could explain their particular development as well, despite being widely recurrent. Cultural policies are also determined by dominant social values and usually respond to the territorial context. But to what extent are these also enabling factors for the development of cultural projects with specific social goals? The present article intends to study the emergence of cultural projects with a clear intentionality of social impact in the local context of Barcelona. Starting from the analysis of 14 cases, the article evaluates the exogenous and endogenous factors and typologies of programmes implemented in order to understand the non-linear complexity of social impact generation in the case of cultural projects.

El presente artículo tiene como propósito analizar la evaluación de los aprendizajes en condiciones de educación remota, a partir de las estrategias de acompañamiento, monitoreo y herramientas o recursos educativos que utiliza un profesor que imparte la asignatura de español en educación secundaria. Es un estudio de corte cualitativo que utilizó como técnica de investigación la observación. Se advierte que, cuando el alumnado tiene acceso a la lectura de manera previa al examen y ello se acompaña de anotaciones, se posibilita movilizar procesos cognitivos complejos como integrar y comparar, con cierto éxito. Se identificó que el alumnado que interactuaba en las sesiones sincrónicas y asincrónicas con el maestro, a través de prender la cámara, proyectar y compartir sus trabajos en Zoom y Classroom, mejoraba las construcciones de su aprendizaje, era constante en la entrega de sus actividades y obtenía buenas notas. Los procesos de evaluación en educación remota no deben replicar con exactitud lo que se realiza en presencial, puesto que las condiciones y las interacciones en tal escenario demandan un cambio.

Obesity and being overweight are very important public health issues due to their increasing prevalence worldwide. Third-wave cognitive behavioural therapies (3wCBT) have emerged in the last few years to promote weight loss. However, the scientific evidence identifying the most commonly used 3wCBT in weight-loss interventions in adults is still needed. The objective of this scoping review will be to identify the most widely researched 3wCBT used to facilitate weight loss in an adult population who are overweight and obese, according to the published scientific literature. The search will be carried out independently by two authors in PubMed (MEDLINE), Scopus, EMBASE, Web of Science, and PsycINFO, using search equations that contain keywords related to our search question: (1) population: adult and elderly population, (2) intervention: terms related to 3wCBT, and (3) results: weight loss or weight management. The data extraction will be performed following the indications of the Cochrane manual, and the results will be presented in three tables. The 3wCBTs have shown promising results for weight loss, but it is not yet known which of them is the most widely used to achieve weight loss in the adult population. Thus, the results of this scoping review could guide professionals in the psychological treatment of obesity and being overweight.

Eating is considered one of the activities of daily living most affected by autism spectrum disorder (ASD) in children and adolescents and, therefore, needs to be thoroughly assessed using specific tools. The aim of this scoping review was to describe the most widely used tool to assess diet in children and adolescents with ASD. A search was conducted on PubMed, Scopus, EMBASE, Web of Science and PsycINFO databases. Two authors screened the articles and included all randomized or non-randomized studies published in English or Spanish in the last five years in which the diet of children and adolescents with ASD was assessed. Fifteen studies were included in this review. Mealtime behaviour was the most assessed variable in the included studies (n = 7). Thirteen different assessment tools were identified to evaluate the diet of children and adolescents with ASD, mainly at ages 2–12 (n = 11). The Brief Assessment scale for Mealtime Behavior in Children (BAMBI) and 24-h recalls were the most commonly used dietary assessment tools in the included studies. Our results can help professionals in the selection of an optimal scale to assess diet in children and adolescents with ASD.

A novel manufacturing process is presented for producing nanopowders and thin films of CuCoO2 (CCO) material. This process utilizes three cost-effective synthesis methods: hydrothermal, sol-gel, and solid-state reactions. The resulting delafossite CuCoO2 samples were deposited onto transparent substrates through spray pyrolysis, forming innovative thin films with a nanocrystal powder structure. Prior to the transformation into thin films, CuCoO2 powder was first produced using a low-cost approach. The precursors for both powders and thin films were deposited onto glass surfaces using a spray pyrolysis process, and their characteristics were examined through X-ray diffraction, scanning electron microscopy, HR-TEM, UV-visible spectrophotometry, and electrochemical impedance spectroscopy (EIS) analyses were conducted to determine the conductivity in the transversal direction of this groundbreaking material for solar cell applications. On the other hand, the sheet resistance of the samples was investigated using the four-probe method to obtain the sheet resistivity and then calculate the in-plane conductivity of the samples. We also investigated the aging characteristics of different precursors with varying durations. The functional properties of CuCoO2 samples were explored by studying chelating agent and precursor solution aging periods using Density Functional Theory calculations (DFT). A complementary Density Functional Theory study was also performed in order to evaluate the electronic structure of this compound. Resuming, this study thoroughly discusses the synthesis of delafossite powders and their conversion into thin films, which hold potential as hole transport layers in transparent optoelectronic devices.

BackgroundThe COVID-19 pandemic has affected the implementation of most ongoing clinical trials worldwide including the PREDIMED-Plus study. The PREDIMED-Plus is an ongoing, multicenter, controlled intervention trial, aimed at weight-loss and cardiovascular disease prevention, in which participants were randomized (1:1 ratio) to an intervention group (energy-reduced Mediterranean diet, promotion of physical activity, and behavioral support) or to a control group (Mediterranean diet with usual care advice). When the pandemic began, the trial was in the midst of the planned intervention. The objective of this report was to examine the effects of the pandemic on the delivery of the intervention and to describe the strategies established to mitigate the possible adverse effects of the pandemic lockdown on data collection and adiposity.MethodsWe assessed the integrity of the PREDIMED-Plus trial during 5 identified periods of the COVID-19 pandemic determined according to restrictions dictated by the Spanish government authorities. A standardized questionnaire was delivered to each of the 23 PREDIMED-Plus recruiting centers to collected data regarding the trial integrity. The effect of the restrictions on intervention components (diet, physical activity) was evaluated with data obtained in the three identified lockdown phases: pre lockdown, lockdown proper, and post lockdown.ResultsDuring the lockdown (March/2020-June/2021), 4,612 participants (48% women, mean age 65y) attended pre-specified yearly follow-up visits to receive lifestyle recommendations and obtain adiposity measures. The overall mean (SD) of the proportions reported by each center showed that 40.4% (25.4) participants had in-person visits, 39.8% (18.2) participants were contacted by telephone and 35% (26.3) by electronic means. Participants’ follow-up and data collection rates increased across lockdown periods (from ≈10% at onset to ≈80% at the end). Compared to pre-lockdown, waist circumference increased during (0.75 cm [95% CI: 0.60–0.91]) and after (0.72 cm [95% CI: 0.56–0.89]) lockdown. Body weight did not change during lockdown (0.01 kg [95% CI: –0.10 to 0.13) and decreased after lockdown (-0.17 kg [95% CI: –0.30 to –0.04]).ConclusionMitigating strategies to enforce the intervention and patient’s follow-up during lockdown have been successful in preserving the integrity of the trial and ensuring its continuation, with minor effects on adiposity.Clinical trial registrationhttps://doi.org/10.1186/ISRCTN89898870, identifier ISRCTN89898870.

ObjectiveWe assessed the association between usual olive oil consumption (OOC) and all-cause, cardiovascular (CVD) and cancer mortality in an adult population in Spain.Materials and methodsOOC was evaluated at baseline in 1,567 participants aged 20 years and older from the Valencia Nutrition Study in Spain using validated food frequency questionnaires. During an 18-year follow-up period, 317 died, 115 due to CVD and 82 due to cancer. Cox regression models were used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (95%CI).ResultsAfter adjusting for demographic and lifestyle factors, the OOC was associated with a lower risk of all-cause, CVD and cancer mortality. Compared to the less than once per month consumption, the consumption of up to one tablespoon per day was associated with a 9% lower risk of all-cause mortality (HR: 0.91; 95%CI: 0.68-1.22) and the consumption of 2 or more tablespoons with a 31% lower risk of all-cause mortality (HR: 0.69; 95%CI: 0.50–0.93; p-trend = 0.011). The consumption of 2 or more tablespoons per day was also associated with lower risk of mortality for CVD (HR: 0.54; 95%CI: 0.32–0.91; p-trend = 0.018) and cancer (HR: 0.49, 95%CI: 0.26–0.94; p-trend = 0.019).ConclusionHigher olive oil consumption was associated with lower long-term risk of all-cause, CVD and cancer mortality in an adult Mediterranean population. The maximum benefit was observed for the consumption of two or more tablespoons per day.

Resumen: En este documento se refieren las bases legales nacionales y, más en concreto, las autonómicas andaluzas que dan respaldo a la figura del profesor contratado doctor vinculado y a la posibilidad de convocar las plazas correspondientes en las facultades de medicina de las universidades públicas españolas. Se exponen, asimismo, las características asistenciales y académicas que deben darse para llevar a cabo la convocatoria pública de dichas plazas. Se resume, a continuación, cuál es la situación actual existente en relación con dicha figura del profesorado en las facultades de medicina españolas. Se analizan también las ventajas y las posibles limitaciones que actualmente se derivan de contar con profesores contratados doctores vinculados y ello tanto para los médicos especialistas eventualmente interesados en optar a una de estas plazas como para el centro sanitario y la facultad de medicina correspondientes. Finalmente, se reseña la posible utilidad del documento elaborado por la Conferencia Nacional de Decanos de Facultades de Medicina de España (CNDFME) en la Asamblea General que se celebró en la Facultad de Medicina de Oviedo del 17 al 19 de mayo del 2018 y actualizado en marzo de 2020. Abstract: A discussion is presented on the national legal foundations, and more specifically, those of Andalusia, that support the figure of the tenure-eligible lecturer and the possibility of filling the corresponding positions in the faculties of medicine in Spanish public universities are discussed. The clinical and academic characteristics that they must have in order to fill those public positions are also presented. The current situation as regards such a figure as a lecturer in Spanish faculties of medicine is then summarised. An analysis is made of the advantages and the possible limitations arising from having a tenure-eligible lecturer, and how this affects both the medical specialists possibly interested in opting for one of these positions, as well as for the corresponding health centres and faculties of medicine. Finally, mention is made of the possible use of the document prepared by the National Conference of Medical Faculty Deans (CNDFME) in the General Assembly held in the Oviedo Faculty of Medicine from 17 to 19 May 2018, and updated in March 2020.

El presente artículo tiene como propósito caracterizar y analizar las prioridades de política educativa implementadas por la administración de gobierno (2012-2018), y las asocia con el impacto que pudieron tener en los últimos resultados PISA, en términos del acceso, equidad y calidad de la educación. Se utiliza el enfoque de las prioridades para el estudio de las siguientes prioridades de política educativa: 1) el acceso a la escuela, 2) el Programa para Abatir el Rezago Educativo, el Programa de Escuelas de Tiempo Completo y el Programa de Inclusión y Alfabetización Digital y 3) la política de evaluación docente. En el estudio se da cuenta, a través de la evidencia, que algunas acciones tuvieron un efecto positivo en los logros de aprendizaje de los y las estudiantes, así como debilidades considerables en el proceso de implantación de las políticas educativas. Se necesitan dispositivos de política educativa que se les dé seguimiento en términos de evaluarlos y focalizarlos. La política educativa tiene que gozar de cierta estabilidad, coherencia, coordinación y buscar el bienestar general, si de verdad se aspira a la calidad y equidad educativa.

El propósito del presente escrito es describir y analizar las acciones de política educativa diseñadas e implementadas por la administración del gobierno actual ante las condiciones de contingencia sanitaria. La respuesta de nuestras autoridades educativas ante tal emergencia fue plantear la educación a distancia con el uso de recursos tecnológicos, para dar continuidad a los aprendizajes de niñas, niños y adolescentes. Se advierte que las acciones de políticas educativas implantadas en México no son equitativas ni inclusivas, pues hay un amplio sector de la población que no se ha podido atender y al que se le mantiene excluido de tal beneficio. Hay diversos factores asociados a la concreción en la continuidad de los aprendizajes como: priorización en el financiamiento, problemas en la disponibilidad y acceso a los recursos tecnológicos, crisis económica y alimentaria, dificultades en el uso de los recursos tecnológicos por parte de docentes, alumnos y padres de familia, capacitación docente en educación a distancia, problemas de conectividad, falta de prioridad en lo pedagógico, entre otros. Se sugiere una política educativa visionaria, basada en la cooperación y que parta de los contextos diferenciados.

Resumen: Objetivo: 1) Determinar la percepción de seguridad que tienen los/las profesionales sanitarios/as y no sanitarios/as en un hospital universitario; 2) describir el clima de seguridad con sus fortalezas y debilidades; y 3) evaluar las dimensiones valoradas negativamente y establecer áreas de mejoras. Método: Estudio transversal y descriptivo realizado en el Hospital Universitario San Juan de Alicante en el que se recogen los resultados de la valoración del nivel de cultura de seguridad utilizando como instrumento de medición la encuesta Hospital Survey on Patient Safety Culture de la Agency for Healthcare Research and Quality adaptada al español. Resultados: La tasa de respuesta fue del 35,36%. El colectivo con mayor participación fue el médico (32,3%), y el servicio más implicado, el de urgencias (9%). El 86,4% tuvo contacto con el paciente. El 50% de los/las trabajadores/as calificó el clima de seguridad entre 6 y 8 puntos. El 82,8% no notificó ningún evento adverso en el último año. Los profesionales con mayor cultura de seguridad fueron los farmacéuticos, y los que tuvieron peor cultura, los celadores. No se identificó ninguna fortaleza de manera global. Hubo dos dimensiones que se comportaron como una debilidad: la 9 (dotación de personal) y la 10 (apoyo de la gerencia a la seguridad del paciente). Conclusiones: La percepción sobre seguridad del paciente es buena, aunque mejorable. No se han identificado fortalezas. Las debilidades identificadas son dotación de personal, apoyo de la gerencia a la seguridad del paciente, cambios de turno y transición entre servicios, y percepción de seguridad. Abstract: Objective: 1) To determine the perception of safety of health professionals and non-health professionals in a university hospital; 2) describe the climate of safety with its strengths and weaknesses; 3) evaluate the negatively valued dimensions and establish areas of improvement. Method: A cross-sectional and descriptive study carried out at the San Juan University Hospital in Alicante, where the results of the assessment of the safety culture level are collected using Hospital Survey On Patient Safety survey of the Agency for Healthcare Research and Quality adapted to Spanish language. Results: The response rate was 35.36%. The group with the greatest participation was the physician (32.3%) and the service most involved, urgencies (9%). 86.4% had contact with the patient. 50% of workers rated the safety climate between 6 and 8 points. 82.8% did not report any adverse events in the last year. The professionals with the greatest security culture were the pharmacists and with the worst culture, the guards. No strength was identified globally. There were two dimensions that behaved like a weakness: 9 (staffing) and 10 (management support for patient safety). Conclusions: The patient's perception of safety is good, although it can be improved. No strengths have been identified. The weaknesses identified are staffing, management support for patient safety, handoffs and transitions, and safety perception.

Abstract Background In the face of the medical workforce shortage, several countries have promoted the opening of medical schools and the expansion of undergraduate and specialization education in medicine. Few studies have compared the characteristics and effects of expanding the supply of general practitioners and specialist physicians between countries. Brazil and Spain, two countries with distinct historical processes and socioeconomic scenarios, yet both with universal public health systems and common aspects in training and medical work, have registered a significant increase in the number of physicians and can be used to understand the challenges of strategic planning for the medical workforce. Methods This study provides a descriptive approach using longitudinal data from official databases in Brazil and Spain from 1998 to 2017. Among the comparable indicators, the absolute numbers of physicians, the population size, and the physician’s ratio by inhabitants were used. The number of medical schools and undergraduate places in public and private institutions, the supply of residency training posts, and the number of medical specialists and medical residents per 100 000 inhabitants were also used to compare both countries. Seventeen medical specialties with the highest number of specialists and comparability between the two countries were selected for further comparison. Results Due to the opening of medical schools, the density of physicians per 1 000 inhabitants grew by 28% in Spain and 51% in Brazil between 1998 and 2017. In that period, Spain and Brazil increased the supply of annual undergraduate places by 60% and 137%, respectively. There is a predominance of private institutions providing available undergraduate places, and the supply of medical residency posts is smaller than the contingent of medical graduates/general practitioners each year. Conclusion Both countries have similar specialist densities in cardiology, dermatology, and neurosurgery specialties. However, family medicine and community in Spain has 91.27 specialists per 100 000 inhabitants, while in Brazil, the density is only 2.64. The comparative study indicated the complexity of the countries’ decisions on increasing the medical supply of general practitioners and specialist physicians. Research and planning policies on the medical workforce must be aligned with the actual health needs of populations and health systems.

Clara Paz,1 Mari Aguilera,2 Marta Salla,3 Victoria Compañ,3 Joan C Medina,3,4 Arturo Bados,3 Eugeni García-Grau,3 Antoni Castel,5 José Cañete Crespillo,6 Adrián Montesano,7 Leticia Medeiros-Ferreira,8 Guillem Feixas3,4 1School of Psychology, Universidad de Las Américas, Quito, Ecuador; 2Department of Cognition, Development and Educational Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain; 3Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain; 4The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain; 5Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain; 6Department of Psychiatry, Hospital de Mataró, Mataró, Spain; 7Faculty of Psychology and Educational Sciences, Universitat Oberta de Catalunya, Barcelona, Spain; 8Nou Barris Nord Adult Mental Health Centre, Barcelona, SpainCorrespondence: Clara Paz Jose Queri y Av, De Los Granados, Quito EC170125, EcuadorTel +593 2 3981000 ext. 2518Email clara.paz@udla.edu.ecBackground: Fibromyalgia (FM) is a debilitating syndrome, more prevalent in women, which is aggravated by the presence of depressive symptoms. In the last decade, cognitive behavioral therapy (CBT) has demonstrated to reduce such depressive symptoms and pain in these patients, but there are still a considerable number of them who do not respond to interventions. The complexity of the disorder requires the consideration of the unique psychological characteristics of each patient to attain good outcomes. One approach that could accomplish this goal might be personal construct therapy (PCT), an idiographic approach that considers identity features and interpersonal meanings as their main target of intervention. Then, the aim of the study is to test the efficacy of PCT as compared to a well-established treatment in the reduction of depressive symptoms in women with fibromyalgia.Methods and Analysis: This is a multicenter randomized controlled trial. In each condition participants will attend up to eighteen 1-hr weekly therapy sessions and up to three 1-hr booster sessions during the following 3– 5 months after the end of treatment. The depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) will be the primary outcome measure and it will be assessed at baseline, at the end of therapy, and at 6-month follow-up. Other secondary measures will be applied following the same schedule. Participants will be 18- to 70-years-old women with a diagnosis of FM, presenting depressive symptoms evinced by scores above seven in depression items of the HADS-D. Intention-to-treat and complete case analyses will be performed for the main statistical tests. Linear mixed models will be used to analyze and to compare the treatment effects of both conditions.Trial Registration: ClinicalTrials.gov: NCT02711020.Keywords: psychotherapy, pain, repertory grid technique, study protocol, CBT, personal construct therapy

Aim To assess the association between self-reported health (SRH) and mortality from all-causes, cardiovascular disease (CVD) and cancer, in adults 65 years and older in Spain. Methods We analysed data of 894 adults (504 women, 390 men) aged 65 years and above from two population-based studies, the EUREYE-Spain study and the Valencia Nutritional Survey (VNS). SRH was assessed at baseline using a single question which is widely used in epidemiological studies: “Overall, how would you consider your health at present?” and the response options were: 1. Very good, 2. Good, 3. Fair, 4. Poor, 5. Very poor. Deaths were ascertained during a 12-year follow-up period, and we used Cox proportional hazards regression models to obtain adjusted hazard ratios (HR). Results During the 12 years of follow-up (8566.2 person-years), we observed 400 deaths, 158 (39.5%) due to CVD and 89 (22.3%) due to cancer. Fair and poor/very poor SRH were significantly associated with higher all-cause mortality after 12-years of follow-up, HR = 1.29 (95% CI, 1.03–1.61) and HR 1.53 (95% CI, 1.09–2.15), respectively. We observed evidence of higher CVD mortality among those who reported fair and poor/very poor SRH, although the association was attenuated and lost statistical significance in the fully adjusted models. Conclusion This study suggests that a poor SRH status is associated with a higher all-cause mortality risk among older adults in Spain. Checking SHR status may be useful to plan health care in older adults.

Abstract Background This study explored the association between inactive time and measures of adiposity, clinical parameters, obesity, type 2 diabetes and metabolic syndrome components. It further examined the impact of reallocating inactive time to time in bed, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) on cardio-metabolic risk factors, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Methods This is a cross-sectional analysis of baseline data from 2189 Caucasian men and women (age 55–75 years, BMI 27–40 Kg/m2) from the PREDIMED-Plus study (http://www.predimedplus.com/). All participants had ≥3 components of the metabolic syndrome. Inactive time, physical activity and time in bed were objectively determined using triaxial accelerometers GENEActiv during 7 days (ActivInsights Ltd., Kimbolton, United Kingdom). Multiple adjusted linear and logistic regression models were used. Isotemporal substitution regression modelling was performed to assess the relationship of replacing the amount of time spent in one activity for another, on each outcome, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Results Inactive time was associated with indicators of obesity and the metabolic syndrome. Reallocating 30 min per day of inactive time to 30 min per day of time in bed was associated with lower BMI, waist circumference and glycated hemoglobin (HbA1c) (all p-values

In this work, we report the preparation of Nafion membranes containing two different nanocomposite MF-4SC membranes, modified with polyaniline (PANI) by the casting method through two different polyaniline infiltration procedures. These membranes were evaluated as a polymer electrolyte membrane for water electrolysis. Operating conditions were optimized in terms of current density, stability, and methanol concentration. A study was made on the effects on the cell performance of various parameters, such as methanol concentration, water, and cell voltage. The energy required for pure water electrolysis was analyzed at different temperatures for the different membranes. Our experiments showed that PEM electrolyzers provide hydrogen production of 30 mL/min, working at 160 mA/cm2. Our composite PANI membranes showed an improved behavior over pristine perfluorinated sulfocationic membranes (around 20% reduction in specific energy). Methanol–water electrolysis required considerably less (around 65%) electrical power than water electrolysis. The results provided the main characteristics of aqueous methanol electrolysis, in which the power consumption is 2.34 kW h/kg of hydrogen at current densities higher than 0.5 A/cm2. This value is ~20-fold times lower than the electrical energy required to produce 1 kg of hydrogen by water electrolysis.

Play as a therapeutic strategy can help to improve daily functioning in children and adolescents with autism spectrum disorder (ASD). Play-based intervention can thus be an optimal option for treatment of this population. Our aim was to describe play-based interventions used in children and adolescents with ASD. We conducted a scoping review. A peer-reviewed literature search was conducted on PubMed, Scopus, EMBASE, Web of Science and PsycINFO databases. We included experimental studies which analyzed play-based interventions in children and adolescents with ASD, which were published in English/Spanish with full text available. We used three tables elaborated a priori to perform data extraction by two authors. Fifteen studies were included, mostly conducted in Australia and published during the past 10 years. Play-based intervention was categorized into three groups: new technologies, symbolic play or official techniques. Interventions lasted approximately 11 weeks, contained one weekly session of 30–60 min and were delivered by parents and teachers. Play-based interventions using new technologies were the most used. Intervention duration and number of sessions varied between articles. Further studies are needed to create play-based intervention protocols which can be implemented in clinical practice with children and adolescents with ASD, thus promoting evidence-based interventions in this field.

Background and purpose: caregivers of people with dementia (PwD) often experience a significant caregiver burden. Occupational Therapy (OT) is a helpful discipline for improving quality of life and other health factors for these caregivers. We conducted a Scoping Review to describe OT interventions for caregivers of PwD. Methods: two authors searched PubMed, Scopus, EMBASE and Web of Science databases and OT journals indexed in the Journal Citation Reports. Terms included in the search strategy were: dementia, Alzheimer, Parkinson, caregivers and OT. We included articles with experimental design in which an OT intervention in caregivers of PwD was carried out, written in Spanish or English and with the full text available. Results: a total of 2121 articles were obtained, 31 of which were included; 22 of them described home-based OT interventions: Tailored Activity Program (TAP) (n = 5), Environmental Skill-Building Program (ESP) (n = 4) and Advancing Caregiver Training (ACT) (n = 3) and other household interventions (n = 10); the remaining studies described OT interventions in other settings (n = 9). Conclusions: OT interventions for caregivers of PwD were mainly carried out at home. The most commonly used interventions were TAP focused on caregivers of people with Alzheimer’s disease, aimed at lessening the burden, depression and stress experienced by caregivers.

The consumption of ultra-processed foods (UPF) has been associated with higher all-cause and cardiovascular disease (CVD) mortality, although this association has not been sufficiently investigated in Mediterranean populations. We aimed to evaluate the association between UPF consumption and all-cause, CVD and cancer mortality in an adult population in Spain. We analysed data from 1,538 participants aged 20 years and above in the Valencia Nutrition Survey in 1995. Diet was assessed at baseline using a validated food frequency questionnaire and the consumption of UPF was calculated using the NOVA system. Information on socio-demographic characteristics, lifestyles, and presence of diseases was also collected at baseline. Cause of death was ascertained during an 18-year follow-up period. We used Cox regression and competing risk models as proposed by Fine and Gray's to estimate adjusted hazard ratios (HR) and 95 % confidence intervals (95 %CI). After 18 years of follow-up, we documented 312 deaths (36.5 % of CVD and 25.6 % of cancer). Compared with participants in the lowest tertile of UPF consumption, those in the highest tertile showed 40 % higher risk of all-cause mortality, HR 1.40 (95 %CI: 1.04–1.90), and evidence of a higher CVD mortality, HR 1.39 (95 %CI: 0.80–2.41) and of cancer mortality, HR 1.53 (95 %CI: 0.83–2.82). This study suggests that a high UPF consumption is associated with a higher all-cause mortality in a Mediterranean population after a long follow-up period. Considering the increase in UPF consumption and their detrimental health effects on mortality, these results should be confirmed by other studies in other populations. [ABSTRACT FROM AUTHOR]

Resumen: Introducción: La prueba evaluación clínica objetiva y estructurada (ECOE) es un método de evaluación de la competencia clínica con evidencia de validez, objetividad y confiabilidad. En este estudio nos propusimos analizar la prueba ECOE de los estudiantes de sexto del grado de medicina. Material y métodos: Estudio transversal de la prueba ECOE realizada en la Facultad de Medicina de la Universidad Miguel Hernández de Elche en junio de 2016. Resultados: En la prueba participaron 116 alumnos. Había 7 (35%) estaciones de paciente estandarizado, 5 (25%) estaciones de informe, 4 (20%) estaciones de maniquí/procedimiento y 4 (20%) estaciones de tipo examen oral estructurado. La mediana de la puntuación de los alumnos fue de 7,14 (recorrido intercuartílico: 6,90-7,43). La mediana de la puntuación de los alumnos del primer día por la mañana fue de 7,10, del primer día por tarde fue superior (7,14) y la del segundo día por la mañana también lo fue (7,24; p = 0,1). La estación con menor puntuación fue la de informe (6,41) y la estación con mayor puntuación fue la de maniquí/procedimiento (7,88) (p

El propósito de la presente investigación cualitativa es mostrar las experiencias de los directivos al momento de tomar una decisión para asignar la materia a impartir por parte de los docentes de educación secundaria. Se considera que los factores que pondera el directivo giran en torno a lo pedagógico, siendo la evaluación interna y externa un instrumento que permite captar la apreciación pedagógica. El trabajo da cuenta de los elementos que consideran tres directivos para organizar la planta docente a su cargo, a través de una entrevista semiestructurada, cuestión que se contrastó con documentos y lineamientos. El análisis de lo que refieren los directivos permitió construir dos categorías que estos actores consideran para organizar la planta docente: las evaluaciones externas y las internas, así como la valoración de éstos de las formas distintas y variadas de los diferentes elementos que las configuran. Se plantea que la decisión del directivo no es lineal, sino interactiva y en ocasiones caótica.

En este artículo de revisión se presentan dos casos del área de bioenergía en relación con la producción de energía vía descomposición del trifosfato de adenosina (ATP). El primero, es el trabajo que realiza el cuerpo humano debido a la contracción del músculo esquelético y el segundo el proceso de difusión de oxígeno en la córnea. Se exponen los antecedentes químico-físicos de la producción y utilización de la molécula energética por excelencia del ATP. Se analizan desde el punto de vista termodinámico, la generación de moléculas bioenergéticas tanto en la respiración aeróbica como en glicólisis anaeróbico. En este sentido, se presentan los procesos de biosíntesis para la utilización de la energía que almacenan las moléculas de ATP y se describe el transporte activo de moléculas en contra de gradientes de concentración. El transporte vesicular de proteínas, la permeabilidad de iones a través de las membranas envolventes a las paredes celulares por medio de las denominadas bombas de sodio-potasio. Posteriormente, se establecen algunos detalles acerca de los mecanismos por medio de los cuales se da la contracción muscular, haciendo referencia a la estructura de las fibras musculares. En el segundo caso, se muestra el estudio de la fisiología de la córnea, donde también se genera trabajo químico para mantener su transparencia a la luz, proveniente del exterior del ojo. Lo que conlleva a la conservación de la estructura adecuada de las células del endotelio, estroma y epitelio. Así mismo, se ilustra el requerimiento de trabajo osmótico para mantener el balance del pH en la córnea, cuando se encuentra con una deficiencia de oxígeno. En tal circunstancia se genera un flujo contra osmótico desde el humor acuoso hacia el estroma que tiende a contrarrestar el aumento de acidez.

La reforma educativa vigente enfatizó acciones de tipo administrativo y laboral. El Servicio Profesional Docente considera cuatro aspectos del ámbito laboral de los docentes de educación básica: el ingreso, la movilidad, la permanencia y el reconocimiento. Se recupera el aspecto de ingreso a la docencia, en términos de la implicación que hay de ello en la organización docente.

Food selectivity is common in children with autism spectrum disorder (ASD). It can be defined as the unwillingness to eat common or new foods, resulting in a lack of variety in the diet or limited food consumption for multiple reasons, such as inflexibility or sensory alterations. We conducted a peer scoping review to describe the interventions that are carried out from occupational therapy (OT) in children with ASD with food selectivity. Two authors independently searched the databases PubMed, Scopus, Web of Science, and EMBASE, as well as the OT journals indexed in Journal Citation Reports. Articles exploring OT interventions in children (≤12 years) with ASD and food selectivity, published in Spanish or English, with experimental design, and with full text available were included. Of the 1445 articles identified, 8 articles met the inclusion criteria. Three main intervention categories were identified: sensory–behavioral, family focused, and other interventions. Most of the interventions from OT were aimed at treating sensory–behavioral aspects. Only three articles described interventions led exclusively by occupational therapists, and the rest were led by a multidisciplinary team. Finally, although these interventions are not exclusive to OT, occupational therapists can participate together with other professionals as an essential component in the treatment of food selectivity in children with ASD.

Objective: Pharmacotherapeutic Follow-up is the Professional Pharmaceutical Care Service aimed at detecting Drug-Related Problems for the prevention and resolution of negative medicine outcomes. The Dader Method is considered a clear and simple tool to develop Pharmacotherapeutic Follow-up. This research aims to analyze the evolution of the international scientific production related to Pharmacotherapeutic Follow-up and the Dader Method to show the current situation of this Professional Pharmacy Assistance Service. In addition, from the data obtained, we give a critical perspective on the implementation of the Dader Method in Community Pharmacy, considering its advantages and disadvantages based on the published scientific literature. Methods: Using bibliometrics tools, indicators were obtained to analyze the international production of scientific articles on Pharmacotherapeutic Follow-up and the Dader Method during the period (1999-2022) through the Scopus database. Results: The results showed a growth in the international scientific production of publications on Pharmacotherapeutic Follow-up, obtaining 30,287 papers, placing the United States, the United Kingdom, Australia, Canada and Spain as the five most productive countries. The publication of 83 papers on the Dader Method places Spain with the highest number of publications, followed by other Spanish or Portuguese speaking countries, among which Brazil and Colombia have the most prominent number of published papers in Latin America. The most frequent international journal covering the topic of Pharmacotherapeutic Follow-up was the American Journal of Health-Pharmacy (12.4%), while on the Dader Method, the journal Pharmaceutical Care Spain (21.7%) is in the first position, followed by Farmacia Hospitalaria (8.4%). Conclusion: The publications on the Dader method highlighs the greater productivity of the University of Granada and the author María José Faus Dáder. The inclusion of patients in the PTF service using the Dader Method, is more frequent in the hospital context, and is based on the presence of defined chronic pathologies (mainly diabetes), polymedication or specialized care follow-up, with elderly population being the most represented in all cases. [ABSTRACT FROM AUTHOR]

The study of the electrochemical catalyst conversion of renewable electricity and carbon oxides into chemical fuels attracts a great deal of attention by different researchers. The main role of this process is in mitigating the worldwide energy crisis through a closed technological carbon cycle, where chemical fuels, such as hydrogen, are stored and reconverted to electricity via electrochemical reaction processes in fuel cells. The scientific community focuses its efforts on the development of high-performance polymeric membranes together with nanomaterials with high catalytic activity and stability in order to reduce the platinum group metal applied as a cathode to build stacks of proton exchange membrane fuel cells (PEMFCs) to work at low and moderate temperatures. The design of new conductive membranes and nanoparticles (NPs) whose morphology directly affects their catalytic properties is of utmost importance. Nanoparticle morphologies, like cubes, octahedrons, icosahedrons, bipyramids, plates, and polyhedrons, among others, are widely studied for catalysis applications. The recent progress around the high catalytic activity has focused on the stabilizing agents and their potential impact on nanomaterial synthesis to induce changes in the morphology of NPs.

Electroelastic materials, as for example, 3M VHB 4910, are attracting attention as actuators or generators in some developments and applications. This is due to their capacity of being deformed when submitted to an electric field. Some models of their actuation are available, but recently, viscoelastic models have been proposed to give an account of the dissipative behaviour of these materials. Their response to an external mechanical or electrical force field implies a relaxation process towards a new state of thermodynamic equilibrium, which can be described by a relaxation time. However, it is well known that viscoelastic and dielectric materials, as for example, polymers, exhibit a distribution of relaxation times instead of a single relaxation time. In the present approach, a continuous distribution of relaxation times is proposed via the introduction of fractional derivatives of the stress and strain, which gives a better account of the material behaviour. The application of fractional derivatives is described and a comparison with former results is made. Then, a double generalisation is carried out: the first one is referred to the viscoelastic or dielectric models and is addressed to obtain a nonsymmetric spectrum of relaxation times, and the second one is the adoption of the more realistic Mooney–Rivlin equation for the stress–strain relationship of the elastomeric material. A modified Mooney–Rivlin model for the free energy density of a hyperelastic material, VHB 4910 has been used based on experimental results of previous authors. This last proposal ensures the appearance of the bifurcation phenomena which is analysed for equibiaxial dead loads; time-dependent bifurcation phenomena are predicted by the extended Mooney–Rivlin equations.