In the context of multiple repurposing of rural spaces, tourism represents a path for development, with the potential to revitalize these areas. The conservation and restoration of heritage, and its promotion through tourism, can become an opportunity for local development, in which a range of stakeholders fulfil different roles in the carrying out of the processes involved. The aim of the study was to analyse the process and results of channelling heritagisation through tourism in Mértola (Baixo Alentejo, Portugal). A series of interviews with the chief stakeholders in the process was conducted, from which the contexts and conceptualisations of development were determined. On the basis of secondary data (statistics), an analysis of the impacts of the process of heritagisation and the development of tourism was undertaken. The objectives of this study consisted in determining: a) the importance of the process of heritagisation in Mértola; b) the viability of the project, given the cost and lack of comprehensive conservation, in creating a unified whole; d) the performance of, and power relationships between, the various stakeholders; e) the limited participation of locals due to disaffection with the project; f) the correlation between heritage, rural tourism and local development.

Background: It is very important that nurses receive adequate training in Sexual and Reproductive Health (SRH). In this study, the contents of the SRH subject in the undergraduate nursing curricula of 77 Spanish universities were examined in order to determine what SRH training nursing students are receiving. Methods: The contents of the SRH subject of all the curricula that were available online were reviewed. The distribution of the contents (topics) in the two areas (reproductive health and sexual health) was analyzed, and the prevalence of each topic was established. It was also determined whether there were differences in topics between public (n=52) and private universities (n=25). Results: The training of nursing students focuses mainly on the area of Reproductive Health (15 topics). Most of the topics of this area had a prevalence greater than 50%. Although the area of Sexual Health had 14 topics, most of these topics had a low prevalence (<20%), especially in private universities. Conclusions: It was found that there is considerable variation in the distribution and prevalence of SRH topics between universities. The contents of the area of Reproductive Health are usually prevalent in most of the curricula, however the contents of the area of Sexual Health are very limited in most of the universities. An organizational effort is required to determine and standardize the contents of SRH that nursing students should receive in Spain to avoid inequalities in their training.

In the last decade there has been a growing interest in infrared thermography in the field of sports medicine in order to elucidate the mechanisms of thermoregulation. The aim of this study was to describe bilateral variations in skin temperature of the anterior thigh and patellar tendon in healthy athletes, to provide a model of baseline tendon and muscle thermoregulation in healthy sprinters following a unilateral isokinetic fatigue protocol. Fifteen healthy national-level sprinters underwent unilateral isokinetic force testing and electrostimulation in which body temperature was measured before, during, and after the protocol using an infrared thermographic camera. ANOVA detected a significant difference in the time x side interaction for patellar temperature changes (p≤0.001) and a significant difference in the time x side interaction for quadriceps temperature changes (p≤0.001). The thermal challenge produces homogeneous changes evident in quadriceps areas, but not homogeneous in tendon areas. these data show that metabolic and blood flow changes may depend on the physical and mechanical properties of each tissue.

Power Electronic development determines introduction of nonlinear devices in Electric Power Systems. Introduction of nonlinear devices increase current harmonics in Transmission and Distribution Power Systems. Distribution transformers and feeders increase power losses and their nominal parameters are reduced. Present work introduces a procedure to evaluate maximum permissible load in single phase distribution transformers with massive introduction of a new type of nonlinear load which changes daily demand graphs.

Background: In recent years, the abusive use of the smartphone has reached a situation that could be considered pathological, although there is no such classification in the DSM-IV. In this sense, different instruments to assess this problematic use or addiction to the smartphone are used. Among them, we found the SPAI, which has been validated in the Spanish language. The main difficulty of these scales is to establish a cut-off point that determines such mobile addiction. On the other hand, self-perception has been used in different addictions as a predictor of the problem. Aim: The objective of this study is to establish the cutting point in the scores of the SPAI scale validated in Spanish, using as a referent the self-perception of addiction values. Methods: A receiver operating characteristics (ROC) analysis was carried out, establishing as the cut-off point the one that presented a higher value of Youden J, indicative of its sensitivity and specificity. Results: 2598 participants from the university community completed the SPAI-Spain questionnaire. When using the self-perception of smartphone addiction as the benchmark value, a score of 44 has been established as the cutting point of the SPAI questionnaire, with a Youden J corresponding to 0.416. Conclusions: The implementation of a cut-off point of the SPAI questionnaire makes it an instrument that allows early identification of those individuals at risk of addiction as well as the establishment of preventive and/or intervention measures.

The VEMoS AXL system is a new optical biometer based on spectral domain optical coherence tomography (SD-OCT) that has been tested in terms of intrasession repeatability and compared with a swept-source optical coherence tomography biometer (SS-OCT), which is considered the gold standard, for an agreement analysis. A biometric analysis was performed three consecutive times in 120 healthy eyes of 120 patients aged between 18 and 40 years with the SD-OCT system and afterwards a single measurement was obtained with the SS-OCT system. Within-subject standard deviations were 0.004 mm, 4.394 µm and 0.017 mm for axial length (AL), central corneal thickness (CCT), and anterior chamber depth (ACD) measures obtained with the SD-OCT biometer, re-spectively. The agreement between devices was good for AL (Limits of agreement, LoA: -0.04 to 0.03 mm) and CCT (LoA: -4.36 to 14.38 µm), whereas differences between devices were clinically relevant for ACD (LoA: 0.03 to 0.21 mm). In conclusion, the VEMoS AXL system provides consistent measures of anatomical parameters, being most of them interchangeable with those provided by the SS-OCT-based gold standard.

Objective: To assess the spectrum of PET-CT-related large vessel vasculitis (LVV) in a Spanish tertiary center and to determine whether FDG uptake by PET-CT differs between giant cell arteritis (GCA) with predominant cranial or extracranial phenotypes. Methods: The spectrum of patients diagnosed with LVV by PET-CT in a tertiary referral hospital that cares for 450,000 people over a period of two years was reviewed. Moreover, differences in FDG uptake between LVV-GCA with predominantly cranial and extracranial phenotype were analyzed. Results: Eighty patients were diagnosed with LVV by PET-CT. Most were due to systemic vasculitis (n=64; 80%), especially GCA (n=54; 67.5%). Other conditions included the presence of rheumatic diseases (n=4; 3.2%), tumors (n=9; 7.2%), and infections (n=3; 2.4%). LVV-GCA patients with predominant extracranial GCA phenotype were younger (mean ± SD: 68.07 ± 9.91 versus 75.46 ± 7.64 years; p= 0.017) and had a longer delay to the diagnosis (median [interquartile range] 12 [4-18] versus 4 [3-8]; p=0.006), but had PMR symptoms more frequently than those with predominantly cranial GCA phenotype (46.3% versus 15.4%, p= 0.057). When FDG uptake was compared according to the two different disease patterns, no statistically significant differences were observed. However, patients with extracranial LVV-GCA showed a non-significantly higher frequency of vasculitic involvement of lower extremity arteries. Conclusion: Regardless of the predominant phenotype, LVV identified by PET-CT is more commonly due to GCA in the Spanish population. In these GCA patients, younger age, PMR and a higher frequency of lower extremity artery vasculitis suggest the presence of LVV.

Objective: Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are often overlapping conditions. We aimed to determine whether 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) is useful in identifying PMR in the setting of large vessel vasculitis (LVV)-GCA. Methods: Patients diagnosed with LVV-GCA by PET-CT at a tertiary referral hospital for a population of 450,000 people over a two-year period were reviewed. Scoring was performed based on potential significant FDG uptake at up to 16 sites in nine different extravascular areas (SCORE 16). Differences in extravascular sites of significant FDG uptake were evaluated between LVV-GCA with a clinical diagnosis of PMR or not. Results: Fifty-four patients were diagnosed with LVV-GCA by 18F-FDG-PET-CT. Of them, 21 (38.8%) were clinically diagnosed with PMR. Significant extravascular FDG uptake was more frequently observed in those with a clinical diagnosis of PMR. In this sense, the SCORE 16 was higher in those with clinical PMR (5.10 ± 4.05 versus 1.73 ± 2.31 in those without a clinical diagnosis of PMR; p< 0.001). A SCORE 16 involving more than 4 sites of significant FDG uptake yielded a sensitivity of 52% and a specificity of 91% for establishing a clinical diagnosis of PMR associated with LVV-GCA. The best areas of significant FDG uptake to clinically identify PMR in patients with LVV were the shoulder, the greater trochanter and the lumbar interspinous regions with an area under the ROC curve of 0.810 (0.691-0.930). Conclusion: Significant extravascular 18F-FDG-PET-CT uptake may help establish a clinical diagnosis of PMR in patients with LVV-GCA. These patients are more commonly diagnosed with PMR if they have significant FDG uptake in the shoulder, greater trochanter, and lumbar interspinous areas.

Background: The aim of this study was to design and analyze the content validity of an instrument to assess the risk of behaviors associated with the Chemsex phenomenon since there is currently no instrument with this objective. Method: Firstly, a bank of items identified from the literature was elaborated. Secondly, 50 experts with knowledge of the Chemsex phenomenon at the national level were contacted. A Delphi group was formed with them to carry out two rounds of item evaluation (comprehension and appropriateness) using a Likert scale of 1 to 5. To assess linguistic validity, the mean score of the item comprehension scores was used. The content validity index (CVI) and Aiken's V (VdA) were calculated for each item. A minimum value of CVI and VdA of 0.6 was established to include the items in the questionnaire. Results: In the first round of evaluation, 36 experts evaluated 114 items, of which 61 were selected. In a second round, 30 experts evaluated the 61 items selected, leaving the scale finally made up of 52 items. Conclusion: A questionnaire has been designed to assess the risk of behaviors associated with the Chemsex phenomenon. The items that make up the questionnaire have shown adequate content and linguistic validity, so this instrument can be considered valid. The Delphi method proved to be a useful technique for the proposed objective.

An adequate representation of the water infiltration process in the soil allows improving the efficiency in application and the uniformity in surface irrigation. The Green and Ampt model has shown a good representation of the process, and researchers from the United States Department of Agriculture (USDA) determined the values of their parameters for soils of that country, which are shown in tables or through functional relationships and this information is used as reference in several parts of the world, although there is no certainty that they are representative of the soils in Mexico. In this study, the parameters of the Green & Ampt equation were determined and evaluated in some soils of agricultural importance in Mexico. The parameters were obtained in four ways: one of them applied a methodology adapted from Brooks and Corey to quantify the wetting front capillary pressure head and used an permeameter under constant hydraulic head to determine the saturated hydraulic conductivity, and the other three consisted in taking them from three studies reported by the USDA. The values of the parameters suggested in Mexico drastically underestimated the results with relative errors (RE) in a range of -49.0 to -94.0% and the most representative were those obtained with the methodology proposed in this research with RE of -15.0 to 6.0%.

Suicide is a public health problem influenced by a variety of biological, psychological, social, and environmental factors. Recognizing the warning signs at each stage is crucial for prevention and helping those at risk. In this context, body awareness, especially interoceptive body awareness, emerges as a potentially relevant and underexplored factor. In this study, binary logistic regression and linear regression analyses were used to examine the relationship between interoceptive body awareness and suicidal orientation in Colombian university students. In addition, the bootstrap technique was used to resample and estimate the distribution of the data. The results support the idea that greater interoceptive awareness may protect against suicidal orientation by improving emotional regulation. An inverse relationship was found between interoceptive awareness and suicidal ideation. These findings are consistent with previous literature on the importance of body awareness for emotional well-being. Further longitudinal research is needed to explore this relationship in depth.

: Suicide is a serious public health problem, with a global mortality rate of 1.4% of all deaths worldwide, and the leading cause of unnatural death in Spain. The use of clinical simulation has proven to be a beneficial tool in the training of nursing students. Such experiences allow them to develop cognitive and affective skills that are fundamental for the detection of warning signs and use of interventions in cases of people who want to take their own lives. Working in a mental health environment can be difficult for nursing students; therefore, the purpose of this study was to explore the perceptions of nursing students on the approach, management and intervention of suicidal crisis through clinical mental health simulation. Methods: qualitative descriptive phenomenological study through focus groups and reflective narratives in a sample of 45 students. A thematic analysis was performed using ATLAS-ti. Results: After the analysis, three themes were obtained: (a) management and handling of emotions (b) identification of suicide motives (c) intervention in suicidal crisis. Discussion: Clinical simulation in mental health allows students to exercise clinical judgment reasoning, detect warning signs for a better treatment approach, and provide tools for effective intervention and management of patient care. The results of this study indicate that nursing students face challenges in approaching mental health clinical simulation due to lack of prior exposure.