111 research outputs found

    A phone app as an enhancer of students’ motivation in a gamification experience in a university context

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    Los niveles de desinterés y desmotivación de gran parte del alumnado universitario representan uno de los retos más urgentes que debe afrontar el profesorado en la actualidad. En este sentido, cada vez son más los trabajos que evidencian el potencial de la “gamificación” a la hora de incrementar la motivación e implicación de los estudiantes en su proceso formativo. En estrecha relación con esto, las tecnologías digitales y, concretamente, el uso de dispositivos móviles supone un recurso de enorme significatividad para jóvenes y adolescentes. Por tanto, en este trabajo se describe la aplicación “inTIME,disen~adaadhocconlaintencioˊndegestionarlosdiferenteselementosqueconformaronunproyectodegamificacioˊnbasadoenlapelıˊculaInTime.EsteseimplementoˊenlaasignaturaFundamentosdelaEducacioˊnFıˊsica(delsegundocursodelgradoenCienciasdelaActividadFıˊsicayelDeporte,delaUniversidaddeGranadaEspan~a).Deigualmodo,tambieˊnsemuestralarepercusioˊnquetuvoenelalumnadoparticipante,asıˊcomolavaloracioˊnquehicierondelamisma.Todoellopermitiraˊalosdocentesconocerunejemploreal,quepuedeservirdeayudaeinspiracioˊnalahoradedisen~arsusfuturosproyectosy,almismotiempo,contarconunnuevoavaldelpotencialdelagamificacioˊnenelaˊmbitoeducativo.Thelevelofdisinterestandlackofmotivationingreatpartoftheuniversitystudentbodyrepresentoneofthemosturgentchallengesthatthefacultymustfacenowadays.Inthisway,therearemoreandmoreprojectsthatshowthepotentialofgamificationwhenitcomestoincreasingmotivationandimplicationofstudentsintheirlearningprocess.Incloserelationship,digitaltechnologiesand,specifically,theuseofmobilephonedevicesentailaresourceofenormousmeaningforyoungadultsandteenagers.Therefore,inthepresentprojectwedescribetheapplicationin TIME”, diseñada “ad hoc” con la intención de gestionar los diferentes elementos que conformaron un proyecto de “gamificación” basado en la película “In Time”. Este se implementó en la asignatura Fundamentos de la Educación Física (del segundo curso del grado en Ciencias de la Actividad Física y el Deporte, de la Universidad de Granada-España-). De igual modo, también se muestra la repercusión que tuvo en el alumnado participante, así como la valoración que hicieron de la misma. Todo ello permitirá a los docentes conocer un ejemplo real, que puede servir de ayuda e inspiración a la hora de diseñar sus futuros proyectos y, al mismo tiempo, contar con un nuevo aval del potencial de la “gamificación” en el ámbito educativo.The level of disinterest and lack of motivation in great part of the university student body represent one of the most urgent challenges that the faculty must face nowadays. In this way, there are more and more projects that show the potential of gamification when it comes to increasing motivation and implication of students in their learning process. In close relationship, digital technologies and, specifically, the use of mobile phone devices entail a resource of enormous meaning for young adults and teenagers. Therefore, in the present project we describe the application “in TIME”, designed ad hoc with the intention to manage the different elements that defined a gamification project based on the movie “In Time”. This was implemented in the course Basis of Physical Education (a second-year course in the BSc in Science of the Physical Activity and Sports in Granada -Spain-). In the same way, it also shows the repercussion that the participating students had, as well the evaluation they did of it. All of this will allow teaching staff to know a real example, which could help them and inspire them when it comes to designing their future projects and, at the same time, they will count with new evidence of the potential of gamification in education

    Gamifying is not playing, but playing helps to gamify

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    Financiación predoctoral de personal investigador en formación por los agentes del Sistema Andaluz del Conocimiento.En la actualidad existe una gran confusión conceptual entre los planteamientos que tienen el juego como referencia, especialmente entre el aprendizaje basado en juegos (ABJ) y la gamificación. Estos surgen con el objetivo de poner el foco del proceso de enseñanza-aprendizaje en el alumnado, partiendo de aquello que le es significativo. Dentro del ABJ encontramos los serious games, que son juegos creados con un objetivo educativo en lugar de centrarse únicamente en la diversión, trabajando diferentes contenidos de manera atractiva. En el presente trabajo se describe el serious game analógico Gami-co, implementado en dos cursos de formación de profesorado con el objetivo de conocer los pilares básicos a la hora de gamificar. Tras ello, se presentan las percepciones y valoraciones que los participantes compartieron sobre el propio proceso formativo y el serious game. Se llevaron a cabo diferentes fases en la implementación del mismo, destacando la fase de juego y la fase posterior de reflexión y explicación teórico-práctica, en la que se establecieron las diferencias entre el ABJ y la gamificación, partiendo de la experiencia vivida. Las valoraciones que los participantes compartieron durante la fase de juego y de reflexión denotan el potencial del serious game en la formación del profesorado en activo.Currently there is a great conceptual confusion between the approaches that have the game as a reference, especially between game-based learning (GBL) and gamification. These arise with the aim of putting the focus of the teaching-learning process on the students, starting from what is significant to them. Within GBL we find serious games, which are created with an educational purpose instead of just for fun, working on different contents in an attractive way. In the present work, the analogical serious game Gami-co is described, implemented in two teacher training courses with the aim of learning the basic pillars of gamification. After that, the perceptions and evaluations that the participants shared about the training process itself and the serious game are presented. Different phases were carried out on its implementation, highlighting the game phase and the subsequent phase of reflection and theoretical-practical explanation, in which the differences between GBL and gamification were established, based on lived experience. The evaluations that the participants shared during the game and reflection phase denote the potential of the serious game in active teacher training.Sistema Andaluz del Conocimient

    Una app móvil potencia la motivación del alumnado en una experiencia de gamificación universitaria

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    Los niveles de desinterés y desmotivación de gran parte del alumnado universitario representan uno de los retos más urgentes que debe afrontar el profesorado en la actualidad. En este sentido, cada vez son más los trabajos que evidencian el potencial de la “gamificación” a la hora de incrementar la motivación e implicación de los estudiantes en su proceso formativo. En estrecha relación con esto, las tecnologías digitales y, concretamente, el uso de dispositivos móviles supone un recurso de enorme significatividad para jóvenes y adolescentes. Por tanto, en este trabajo se describe la aplicación “inTIME,disen~adaadhocconlaintencioˊndegestionarlosdiferenteselementosqueconformaronunproyectodegamificacioˊnbasadoenlapelıˊculaInTime.EsteseimplementoˊenlaasignaturaFundamentosdelaEducacioˊnFıˊsica(delsegundocursodelgradoenCienciasdelaActividadFıˊsicayelDeporte,delaUniversidaddeGranadaEspan~a).Deigualmodo,tambieˊnsemuestralarepercusioˊnquetuvoenelalumnadoparticipante,asıˊcomolavaloracioˊnquehicierondelamisma.Todoellopermitiraˊalosdocentesconocerunejemploreal,quepuedeservirdeayudaeinspiracioˊnalahoradedisen~arsusfuturosproyectosy,almismotiempo,contarconunnuevoavaldelpotencialdelagamificacioˊnenelaˊmbitoeducativo.//Thelevelofdisinterestandlackofmotivationingreatpartoftheuniversitystudentbodyrepresentoneofthemosturgentchallengesthatthefacultymustfacenowadays.Inthisway,therearemoreandmoreprojectsthatshowthepotentialofgamificationwhenitcomestoincreasingmotivationandimplicationofstudentsintheirlearningprocess.Incloserelationship,digitaltechnologiesand,specifically,theuseofmobilephonedevicesentailaresourceofenormousmeaningforyoungadultsandteenagers.Therefore,inthepresentprojectwedescribetheapplicationin TIME”, diseñada “ad hoc” con la intención de gestionar los diferentes elementos que conformaron un proyecto de “gamificación” basado en la película “In Time”. Este se implementó en la asignatura Fundamentos de la Educación Física (del segundo curso del grado en Ciencias de la Actividad Física y el Deporte, de la Universidad de Granada-España-). De igual modo, también se muestra la repercusión que tuvo en el alumnado participante, así como la valoración que hicieron de la misma. Todo ello permitirá a los docentes conocer un ejemplo real, que puede servir de ayuda e inspiración a la hora de diseñar sus futuros proyectos y, al mismo tiempo, contar con un nuevo aval del potencial de la “gamificación” en el ámbito educativo.//The level of disinterest and lack of motivation in great part of the university student body represent one of the most urgent challenges that the faculty must face nowadays. In this way, there are more and more projects that show the potential of gamification when it comes to increasing motivation and implication of students in their learning process. In close relationship, digital technologies and, specifically, the use of mobile phone devices entail a resource of enormous meaning for young adults and teenagers. Therefore, in the present project we describe the application “in TIME”, designed ad hoc with the intention to manage the different elements that defined a gamification project based on the movie “In Time”. This was implemented in the course Basis of Physical Education (a second-year course in the BSc in Science of the Physical Activity and Sports in Granada -Spain-). In the same way, it also shows the repercussion that the participating students had, as well the evaluation they did of it. All of this will allow teaching staff to know a real example, which could help them and inspire them when it comes to designing their future projects and, at the same time, they will count with new evidence of the potential of gamification in education

    Gamification in the Spanish educational field: a systematic review

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    Ante la falta de motivación e implicación del alumnado surgen nuevas estrategias metodológicas que acercan los procesos educativos a los intereses y a las necesidades del estudiante del siglo XXI. Entre ellas destaca la gamificación, que consiste en aplicar los elementos propios del juego en contextos no lúdicos. Esta revisión sistemática pretende conocer la incidencia que la gamificación ha alcanzado en el ámbito educativo español para poder determinar en qué etapas y en qué asignaturas se está aplicando, sobre qué variables se incide y qué resultados se están obteniendo. Para ello se consultaron las bases de datos electrónicas Web of Science (colección principal), Eric y Scopus, contemplando los principios establecidos por la declaración PRISMA para revisiones sistemáticas. De los 118 artículos cribados por el título y el resumen y leídos en su totalidad, solo 15 propuestas cumplieron los criterios de inclusión. En la distribución por etapas educativas el 66.7% de los artículos pertenecen al ámbito universitario, el 20 % a educación secundaria, el 6,7% a bachillerato y el 6,7% restante combinaba el programa en primaria y secundaria. En términos globales, más de la mitad de las propuestas (un 60%) incidieron en variables motivacionales. A pesar del enorme auge de la gamificación en los últimos años, se ha identificado la necesidad de un mayor rigor metodológico y una descripción más exhaustiva de las propuestas para valorar su verdadera potencialidad en nuestro país.In order to face the lack of motivation and involvement of the student body new methodological strategies have emerged aiming to bring the educational processes closer to the interests and necessities of the 21st century’s students. Among them, gamification stands out as a strategy that consists of applying elements from the games in non-ludic contexts. This systematic review seeks to know the impact that gamification has reached in the Spanish educational field to determine in which stages and which courses it is being applied to, on which variables it has an impact on and what are the results that we are obtaining. In order to do this, we consulted digital databases such as: Web of Science (main collection), Eric and Scopus. The principles established by the PRISMA declaration were taken into consideration. Out of the 118 articles filtered by title and abstract, and then read in its entirety only 15 proposals fulfilled the inclusion criteria. In the distribution via different education stages, 66.7% of the articles fall into the category of university education, 20% belongs to mandatory high school education, 6.7% falls into the category of Spanish baccalaureate and the remaining 6.7% combined the program on mandatory primary school and secondary school education. If we think in global terms, more than half of the proposals (60%) had an impact on motivational variables. Despite the rise of gamification in the last few years it has been identified a necessity for a higher methodological exactitude and a more exhaustive description of proposals to value their true potentiality in our country

    El impacto de un doble breakout digital en un proyecto de gamificación

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    Las metodologías activas surgen para promover un rol protagonista y activo por parte de los estudiantes, incidiendo en el aprendizaje y compromiso con su formación. Además, en este contexto, es fundamental enfocar el proceso formativo en educación superior al desarrollo de competencias transferibles a la futura labor profesional, como puede ser la digital. Debido a la significatividad y atractivo que despiertan los juegos en los jóvenes actuales, cabe destacar el aprendizaje basado en juegos, donde se ubican propuestas como los breakouts y los escape rooms, actividades que han tenido un enorme auge en los últimos años. En este artículo se analiza el impacto de un doble breakout digital dentro de un proyecto de gamificación, ambientado en la saga de Harry Potter y denominado Harry Potter: el legado de Dumbledore. En concreto, la propuesta se ha llevado a cabo en el grado de Ciencias de la Actividad Física y el Deporte, de la Universidad de Granada. Para el análisis de la misma se ha utilizado una metodología cualitativa, con el objetivo de conocer las percepciones del alumnado, a través de una pregunta abierta en Google Drive y el uso del software NVivo 11 para su análisis. Los resultados muestran el enorme potencial del breakout en el aula, pues aumenta la gestión emocional, la resiliencia y el aprendizaje del alumnado universitario, siendo para ello un aspecto clave que sea coherente con la narrativa del proyecto de gamificación en el que se enmarca, y que tenga una estética que aumente la inmersión.Active methodologies arise to promote a protagonist and active role from students, influencing their learning and commitment. In this context, it is essential that the training process in higher education is focused on the development of transferable competences to future professional work, such as the digital competence. Due to the meaningfulness and attractiveness of games in today’s young people, game-based learning acquires great relevance, where proposals such as breakouts and escape rooms can be found. These activities have experienced a huge growth in last years. This article analyzes the impact of a double digital breakout in the context of a gamification project set in the Harry Potter saga, and called Harry Potter: Dumbledore’s legacy. Specifically, this proposal has been carried out in the degree of Physical Activity and Sports Sciences, from the University of Granada. To analyze this proposal, a qualitative methodology was followed with the aim of collecting students’ self-perception on the breakout, for which an open question in Google Drive was used for students to respond and the NVivo 11 software was used for the analysis. The results show the enormous potential of the breakout carried out in the classroom, as it increases the emotional management, resilience and learning of college students. A key aspect for this to happen is that the breakout design is coherent with the narrative of the gamification project in which it is framed

    Peer actions for a service learning project to prevent drug-facilitated sexual assaults

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    The service-learning methodology combines active learning processes and community service. This service-learning experience was performed using an interdisciplinary and cross plan. The teachers made a horizontal coordination in the courses, and a vertical coordination in subjects of the Degrees involved. This allowed working together in the students’ curricular training process. It also permitted covering various specific skills, as corresponds to the different subjects, whilst optimizing the students’ workload. The service addressed the problem of drug-facilitated sexual assaults (DFSA) in the youth leisure nightlife. DFSA is the temporary disability of a person caused by a decrease in her/his volitional and cognitive abilities due to the voluntary or involuntary consumption of a psychoactive substance. An active learning about the problem was encouraged in the classroom, focused on recognizing myths, attitudes, and risk situations. The service-learning actions to the community was based on an anonymous survey conducted among the students, which dealt with the problem. The Service Learning was stimulated through the design, planning and development of activities aimed at gaining social awareness of the existing problem while favouring peer learning processes. The students undertook awareness actions at different levels, spreading their message by means of social networks, high school workshops, and information stands on the street.Teaching Innovation projects UAH / EV951 and UAH / EV1024 of the University of Alcalá; Research project MSCBS-PNSD-2018I032 of the Ministry of Health Consumption and Social Welfare, National Drug Plan; IUICP2019 /06 Research project of the University Institute of Police Science Research. P. Prego-Meleiro and F. Zapata thank the UAH for their scholarships.Quintanilla, G.; Ortega-Ojeda, F.; García-Ruiz, C.; Prego-Meleiro, P.; Figueroa Navarro, C.; Bravo-Serrano, B.; García-Pernía, MR.... (2020). Peer actions for a service learning project to prevent drug-facilitated sexual assaults. En 6th International Conference on Higher Education Advances (HEAd'20). Editorial Universitat Politècnica de València. (30-05-2020):1425-1433. https://doi.org/10.4995/HEAd20.2020.11313OCS1425143330-05-202

    Escape room y Breakout en educación superior: escapando de la rutina para abrir la puerta de la motivación y el aprendizaje

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    La falta de motivación de gran parte del alumnado universitario fue uno de los principales motivos que dieron lugar a este proyecto, dado que se ha convertido en uno de los principales retos del profesorado en la actualidad. Las estrategias tradicionales no dan respuesta a las necesidades formativas y personales de los estudiantes del siglo XXI, por lo que se hacen necesarias metodologías activas que les brinden un rol protagonista dentro del proceso de enseñanza-aprendizaje. De este modo, al mismo tiempo, se ha procurado tener presente en todo momento el valor de la significatividad en todos los planteamientos que se han llevado a cabo con el alumnado participante, en un intento de reducir los altos niveles de desmotivación y falta de implicación y compromiso que en muchas ocasiones encontramos en el aula universitaria. Entre las metodologías activas con mayor auge en los últimos años se encuentra el aprendizaje basado en juegos, destacando el enorme auge de los escape rooms y breakouts en los procesos formativos. Dicha circunstancia propició que en el presente proyecto se apostara por aprovechar el potencial de ambos planteamientos para favorecer la motivación y aprendizaje del alumnado, gracias a la significatividad que atesoran para ellos. En este sentido, se establecieron diferentes fases y objetivos para que el alumnado pudiera aprovechar al máximo el potencial tanto de los escape rooms como de los breakouts, y favorecer una adecuada adquisición de los contenidos de las asignaturas “Aprendizaje y Enseñanza de la Educación Física” (del máster de Profesorado) y “Fundamentos de la Educación Física” y “Actividad física y Salud” (del grado en ciencias de la actividad física y el deporte). La puesta en práctica de ellos se ha complementado y enriquecido con dos fases más, una primera fase de reflexión y una última fase de aplicación. Con respecto a los logros alcanzados, cabe destacar el enorme incremento de la motivación que este proyecto ha supuesto en el alumnado. A ello habría que añadir su idoneidad en educación superior, gracias no solo a su incidencia en la motivación e implicación del alumnado, sino también a su viabilidad y, por tanto, a su futura aplicación práctica en cursos sucesivos.The lack of motivation of a large part of the university students was one of the main reasons that gave rise to this project, given that it has become one of the main challenges for teachers today. Traditional strategies do not respond to the training and personal needs of 21st century students, which is why active methodologies are necessary that give them a leading role in the teaching-learning process. In this way, at the same time, an effort has been made to keep in mind at all times the value of significance in all the approaches that have been carried out with the participating students, in an attempt to reduce the high levels of demotivation and lack of involvement. and commitment that we often find in the university classroom. One of the most popular active methodologies in recent years is game-based learning, highlighting the enormous boom in escape rooms and breakouts in training processes. This circumstance led to the commitment in this project to take advantage of the potential of both approaches to promote the motivation and learning of the students, thanks to the significance they hold for them. In this sense, different phases and objectives were established so that the students could make the most of the potential of both the escape rooms and the breakouts, and favor an adequate acquisition of the contents of the subjects "Learning and Teaching of Physical Education" (from the master's degree in Teachers) and "Fundamentals of Physical Education" and "Physical Activity and Health" (from the degree in physical activity and sports sciences). The implementation of them has been complemented and enriched with two more phases, a first phase of reflection and a last phase of application. Regarding the achievements, it is worth noting the enormous increase in motivation that this project has brought to the students. To this should be added its suitability in higher education, thanks not only to its impact on the motivation and involvement of students, but also to its viability and, therefore, its future practical application in successive courses

    Protective role of nrf2 in renal disease

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    Chronic kidney disease (CKD) is one of the fastest-growing causes of death and is predicted to become by 2040 the fifth global cause of death. CKD is characterized by increased oxidative stress and chronic inflammation. However, therapies to slow or prevent CKD progression remain an unmet need. Nrf2 (nuclear factor erythroid 2-related factor 2) is a transcription factor that plays a key role in protection against oxidative stress and regulation of the inflammatory response. Consequently, the use of compounds targeting Nrf2 has generated growing interest for nephrologists. Pre-clinical and clinical studies have demonstrated that Nrf2-inducing strategies prevent CKD progression and protect from acute kidney injury (AKI). In this article, we review current knowledge on the protective mechanisms mediated by Nrf2 against kidney injury, novel therapeutic strategies to induce Nrf2 activation, and the status of ongoing clinical trials targeting Nrf2 in renal diseasesThe authors’work has been supported by grants FIS/Fondos FEDER (PI17/00130, PI17/00257, PI17/01495, PI18/01386, PI19/00815, PI20/00375, PI20/00487 ISCIII-RETIC REDinREN RD016/0009), Sociedad Española de Nefrología, FRIAT, Comunidad de Madrid en Biomedicina B2017/BMD-3686 CIFRA2-CM. Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM) and Cardiovascular (CIBERCV), Spanish Ministry of Science and Innovation (RTI2018-098788-B-100, DTS17/00203, DTS19/00093, RYC-2017-22369, FJC2019-042028), The “PFIS” and “Sara Borrell” training program of the ISCIII supported the salary of MGH (FI18/00310), SR-M (CD19/00021), and CH-B (CP16/00017). Spanish Ministerio de Ciencia, Innovación y Universidades (MICIU) grant RTI2018-100695-B-I00, Junta de Andalucía grants P18-RT-4264, 1263735-R and BIO-276, the FEDER Funding Program from the European Union, and Universidad de Córdoba (to J.M.V.

    Association of objectively measured physical activity and sedentary time with arterial stiffness in women with systemic lupus erythematosus with mild disease activity

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    Objectives To examine the association of objectively measured physical activity (PA) intensity levels and sedentary time with arterial stiffness in women with systemic lupus erythematosus (SLE) with mild disease activity and to analyze whether participants meeting the international PA guidelines have lower arterial stiffness than those not meeting the PA guidelines. Methods The study comprised 47 women with SLE (average age 41.2 [standard deviation 13.9]) years, with clinical and treatment stability during the 6 months prior to the study. PA intensity levels and sedentary time were objectively measured with triaxial accelerometry. Arterial stiffness was assessed through pulse wave velocity, evaluated by Mobil-O-Graph® 24h pulse wave analysis monitor. Results The average time in moderate to vigorous PA in bouts of 10 consecutive minutes was 135.1±151.8 minutes per week. There was no association of PA intensity levels and sedentary time with arterial stiffness, either in crude analyses or after adjusting for potential confounders. Participants who met the international PA guidelines did not show lower pulse wave velocity than those not meeting them (b = -0.169; 95% CI: -0.480 to 0.143; P = 0.280). Conclusions Our results suggest that PA intensity levels and sedentary time are not associated with arterial stiffness in patients with SLE. Further analyses revealed that patients with SLE meeting international PA guidelines did not present lower arterial stiffness than those not meeting the PA guidelines. Future prospective research is needed to better understand the association of PA and sedentary time with arterial stiffness in patients with SLE.This work was supported by Fundación para la Investigación Biosanitaria de Andalucia Oriental, Grant numbers: PI-0525-2016 (http:// www.fibao.es/; http://www.ibsgranada.es/) to JAVH. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

    Recent Changes in Breast Cancer Incidence in Spain, 1980–2004

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    BACKGROUND: Since the 1980s, Spain experienced two decades of sharply increasing breast cancer incidence. Declines in breast cancer incidence have recently been reported in many developed countries. We examined whether a similar downturn might have taken place in Spain in recent years. METHODS: Cases of invasive female breast cancer were drawn from all population-based Spanish cancer registries that had at least 10 years of uninterrupted registration over the period 1980-2004. Overall and age-specific changes in incidence rates were evaluated using change-point Poisson models, which allow for accurate detection and estimation of trend changes. All statistical tests were two-sided. RESULTS: A total of 80,453 incident cases of invasive breast cancer were identified. Overall age- and registry-adjusted incidence rates rose by 2.9% (95% confidence interval [CI] = 2.7% to 3.1%) annually during the 1980s and 1990s; there was a statistically significant change in this trend in 2001 (95% CI = 1998 to 2004; P value for the existence of a change point <.001), after which incidence declined annually by 3.0% (95% CI = 1.8% to 4.1%). This trend differed by age group: There was a steady increase in incidence for women younger than 45 years, an abrupt downturn in 2001 for women aged 45-64 years, and a gradual leveling off in 1995 for women aged 65 years or older. Separate analyses for registries that had at least 15 years of uninterrupted registration detected a statistically significant interruption of the previous upward trend in breast cancer incidence in provinces that had aggressive breast cancer screening programs and high screening participation rates, including Navarra (change point = 1991, P < .001), Granada (change point = 2002, P = .003), Bizkaia (change point = 1998, P < .001), Gipuzkoa (change point = 1998, P = .001), and Araba (change point = 1997, P = .002). CONCLUSIONS: The recent downturn in breast cancer incidence among Spanish women older than 45 years is best explained by a period effect linked to screening saturation.Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) (AC07-005 to M.P., PM07-004 to R.P-B.) and Carlos III Institute of Health (ISCIII-CIBERESP collaborative agreement “Acción Transversal del Cancer”).S
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