Epidemiology of venous leg ulcers in primary health care: Incidence and prevalence in a health centre-A time series study (2010-2014)

The aims of the study were to describe and analyse the temporal trend of the prevalence and incidence of venous leg ulcers (VLU) over the years 2010 to 2014, to determine healing times and temporal trends in the study period, and to evaluate related aspects such as the use of the Ankle-Brachial Pressure Index (ABPI) in a primary care health centre. This was a retrospective study based on a time series (years 2010-2014) of the prevalence and incidence of VLUs in people aged over 40 years in a primary care centre in Barcelona City. We reviewed 3920 electronic health records selecting patients, per year (2010-2014), with VLUs based on the ICD-10 diagnoses. For prevalence, we took into account any patient with an active VLU in the year of study. For incidence, we took into account patients with a new VLU in the year of study. A descriptive analysis was carried out based on each of the collected variables. The variables were examined according to the years of study (time series) by one-factor analysis of variance (ANOVA) or Kruskal?Wallis non-parametric test, as appropriate. A survival analysis by Kaplan?Meier curves and log-rank test was also performed. A total of 139 patients met the VLU criteria. Among them, only 79.2% were classified as having a VLU and had a correct ICD diagnosis. The prevalence and incidence increased over the years, doubling in patients aged over 65 years. Incidence increased from 0.5 new cases per 1000 people/ year in 2010 to 1 new case for every 1000 people/year in 2014. Moreover, the prevalence ranged between 0.8 and 2.2 patients with VLU for every 1000 people/ year. During the study period, a total of 84.2% of the VLUs healed (117/139 VLU). Regarding average annual time to healing, the trend indicates that lesions took less time to heal (Kruskal?Wallis test, P = 0.004), ranging between 453,9 weeks in 2005 to 19 weeks in 2014. The use of ABPI also evolved and was found to be increasingly performed prior to the appearance of the lesion. The epidemiological profile of people affected by VLUs continues to be, mainly, that of women of an advanced age, over 70 years. The frequency of VLU occurrence rose continually over the years, but healing took less time, and use of ABPI improved. Assigning a reference nurse in the wounds unit and the organisational structure around this problem may have an influence on improving care and the approach to these types of lesions

Otro título: #Twiplomacia e innovación‎‎

#KoalaDreamz es un proyecto realizado desde la cuenta de Twitter de la Embajada de España en Australia durante 201

Regionalismo e integración regional en América Latina : el Mercosur: ¿un “nuevo” espacio para la regulación social?

Números monográficos con título distintivo catalogados individualmente.‎Bajo la denominación "Documentos de trabajo" se publican resultados de los proyectos de investigación realizados y promovidos por el CEALCI. Además pueden ser incluidos en esta serie aquellos trabajos que, previa aceptación por el Consejo Editorial, reunan los requisitos de calidad establecidos y coincidan con los objetivos de la Fundación Carolina y su Centro de Estudios.‎Bibliografía: p. 20-23Resumen: El presente documento de trabajo analiza la evolución de los regionalismos en América Latina (AL) en las últimas dos décadas (2000-2020), así como sus perspectivas de futuro. El punto de partida del texto apunta a la hipótesis de que nos encontramos frente a una crisis del regionalismo latinoamericano, proceso marcado por la tendencia hacia la desintegración, cuyos orígenes se remontan al “decenio progresista” y que se profundizan con fuerza tras el “giro a la derecha”, con el telón de fondo de los efectos no superados de la crisis internacional de 2008. Se analiza este devenir tomando en consideración, en primer lugar, los cambios globales recientes, resumidos bajo la idea de una “crisis de la globalización”, con particular énfasis en sus efectos sobre la región. Seguidamente, se examinan las respuestas (o su ausencia) desde los regionalismos latinoamericanos, examinando primero la experiencia progresista y, luego, los cambios y las continuidades tras el giro a la derecha. Finalmente, se concluye con un balance y un examen de las perspectivas a futuro, que incorpora los impactos de la pandemia de la COVID-19, y tanto las potencialidades como los obstáculos para la elaboración de respuestas a este fenómeno de carácter regional

Analysis of the residual safety level in R/C slabs with severe joist corrosion

An analysis until the failure on a series of one-way slabs with severe corrosion at the lower reinforcement of the R/C joists is presented. Different positions in the slab and number of damaged joists have been studied, obtaining the residual safety assessment in cases of slabs damaged by flexural failure mechanisms. Since the boundary conditions have proved decisive for obtaining the behavior, the damaged slab has been evaluated as part of the entire building, as precisely as possible, taking into account the different phases of the construction process and deterioration in time, and the complex behavior of concrete, steel and masonry. The results of the proposed methodology are consistent with the pathology of the observed cases. As a result of this study the authors propose practical recommendations to help in making decisions about the magnitude of the intervention, always necessary in this type of pathology.Vercher Sanchis, JM.; Gil Benso, E.; Mas Tomas, MDLA.; Cubel Arjona, FJ. (2014). Analysis of the residual safety level in R/C slabs with severe joist corrosion. Journal of Performance of Constructed Facilities. 1-14. doi:10.1061/(ASCE)CF.1943-5509.0000608S11

Clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal

Background: Clinical practice guidelines are recommendations systematically developed to assist clinical decision-making and inform healthcare. In current rheumatoid arthritis (RA) guidelines, management of the foot and ankle is under-represented and the quality of recommendation is uncertain. This study aimed to identify and critically appraise clinical practice guidelines for foot and ankle management in RA. Methods: Guidelines were identified electronically and through hand searching. Search terms 'rheumatoid arthritis', 'clinical practice guidelines' and related synonyms were used. Critical appraisal and quality rating were conducted using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Results: Twenty-four guidelines were included. Five guidelines were high quality and recommended for use. Five high quality and seven low quality guidelines were recommended for use with modifications. Seven guidelines were low quality and not recommended for use. Five early and twelve established RA guidelines were recommended for use. Only two guidelines were foot and ankle specific. Five recommendation domains were identified in both early and established RA guidelines. These were multidisciplinary team care, foot healthcare access, foot health assessment/review, orthoses/insoles/splints, and therapeutic footwear. Established RA guidelines also had an 'other foot care treatments' domain. Conclusions: Foot and ankle management for RA features in many clinical practice guidelines recommended for use. Unfortunately, supporting evidence in the guidelines is low quality. Agreement levels are predominantly 'expert opinion' or 'good clinical practice'. More research investigating foot and ankle management for RA is needed prior to inclusion in clinical practice guidelines

Chile y el orden multipolar : autonomía estratégica y diplomacia emprendedora en el nuevo ciclo de la política exterior

Números monográficos con título distintivo catalogados individualmente.Los “Análisis Carolina” son textos centrados en asuntos de actualidad, tratando de desentrañar sus claves y ofrecer recomendaciones de política.Bibliograf.: 12-14Resumen: El “estallido social” que vivió Chile a partir de octubre de 2019 abrió las puertas de un nuevo ciclo de la vida política nacional. Las masivas protestas ciudadanas posibilitaron un, hasta entonces, improbable acuerdo transversal entre las principales fuerzas políticas, para dar inicio a un inédito proceso constituyente que reemplace la Constitución de la República heredada de la dictadura de Augusto Pinochet (1973-1990). Constitución que, aun con importantes reformas, perpetúa un régimen democrático semisoberano y un rol subsidiario del Estado en la economía

Defining complementary tools to the IVI. The Infrastructure Degradation Index (IDI) and the Infrastructure Histogram (HI)

[EN] The Infrastructure Value Index (IVI) is quickly becoming a standard as a valuable tool to quickly assess the state of urban water infrastructure. However, its simple nature (as a single metric) can mask some valuable information and lead to erroneous conclusions. This paper introduces two complementary tools to IVI: The Infrastructure Degradation Index (IDI) and the Infrastructure Histogram (HI). The IDI is focused on time (compared to the IVI, focused on value), represents an intuitive concept and behaves in a linear way. The joint analysis of IVI and IDI provides results in a more complete understanding of the state of the assets, while maintaining the simplicity of the tools. The Infrastructure Histogram allows for a full evaluation of the infrastructure state and provides a detailed picture of network age compared to its expected life, as well as an order of magnitude of the required investments in the following years.Cabrera Rochera, E.; Estruch-Juan, ME.; Gomez Selles, E.; Del Teso-March, R. (2019). Defining complementary tools to the IVI. The Infrastructure Degradation Index (IDI) and the Infrastructure Histogram (HI). Urban Water Journal. 16(5):343-352. https://doi.org/10.1080/1573062X.2019.1669195S343352165Alegre, H., Vitorino, D., & Coelho, S. (2014). Infrastructure Value Index: A Powerful Modelling Tool for Combined Long-term Planning of Linear and Vertical Assets. Procedia Engineering, 89, 1428-1436. doi:10.1016/j.proeng.2014.11.469Amaral, R., Alegre, H., & Matos, J. S. (2016). A service-oriented approach to assessing the infrastructure value index. Water Science and Technology, 74(2), 542-548. doi:10.2166/wst.2016.250Aware-p.org. 2014. “AWARE-P/Software.” Accessed 25 November 2018. http://www.aware-p.org/np4/software/Baseform. 2018. “Baseform.” Accessed 24 November 2018. https://baseform.com/np4/productCanal de Isabel II Gestión. 2012. Normas Para Redes de Abastecimiento. [Standards for Water Supply Networks.]. https://www.canalgestion.es/es/galeria_ficheros/pie/normativa/normativa/Normas_redes_abastecimiento2012_CYIIG.pdfFrost, and Sullivan. 2011. “Western European Water and Wastewater Utilities Market.” https://store.frost.com/western-european-water-and-wastewater-utilities-market.html#section1Leitão, J. P., Coelho, S. T., Alegre, H., Cardoso, M. A., Silva, M. S., Ramalho, P., … Carriço, N. (2014). Moving urban water infrastructure asset management from science into practice. Urban Water Journal, 13(2), 133-141. doi:10.1080/1573062x.2014.939092Marchionni, V., Cabral, M., Amado, C., & Covas, D. (2016). Estimating Water Supply Infrastructure Cost Using Regression Techniques. Journal of Water Resources Planning and Management, 142(4), 04016003. doi:10.1061/(asce)wr.1943-5452.0000627Marchionni, V., Lopes, N., Mamouros, L., & Covas, D. (2014). Modelling Sewer Systems Costs with Multiple Linear Regression. Water Resources Management, 28(13), 4415-4431. doi:10.1007/s11269-014-0759-zPulido-Velazquez, M., Cabrera Marcet, E., & Garrido Colmenero, A. (2014). Economía del agua y gestión de recursos hídricos. Ingeniería del agua, 18(1), 95. doi:10.4995/ia.2014.3160Rokstad, M. M., Ugarelli, R. M., & Sægrov, S. (2015). Improving data collection strategies and infrastructure asset management tool utilisation through cost benefit considerations. Urban Water Journal, 13(7), 710-726. doi:10.1080/1573062x.2015.102469

ECLIM-SEHOP, a new platform to set up and develop international academic clinical trials for childhood cancer and blood disorders in Spain

Introduction: Cancer and blood disorders in children are rare. The progressive improvement in survival over the last decades largely relies on the development of international academic clinical trials that gather the sufcient number of patients globally to elaborate solid conclusions and drive changes in clinical practice. The participation of Spain into large international academic trials has traditionally lagged behind of other European countries, mainly due to the burden of administrative tasks to open new studies, lack of fnancial support and limited research infrastructure in our hospitals. Methods: The objective of ECLIM-SEHOP platform (Ensayos Clínicos Internacionales Multicéntricos-SEHOP) is to overcome these difculties and position Spain among the European countries leading the advances in cancer and blood disorders, facilitate the access of our patients to novel diagnostic and therapeutic approaches and, most importantly, continue to improve survival and reducing long-term sequelae. ECLIM-SEHOP provides to the Spanish clinical investigators with the necessary infrastructural support to open and implement academic clinical trials and registries. Results: In less than 3 years from its inception, the platform has provided support to 20 clinical trials and 8 observational studies, including 8 trials and 4 observational studies where the platform performs all trial-related tasks (integral support: trial setup, monitoring, etc.) with more than 150 patients recruited since 2017 to these studies. In this manuscript, we provide baseline metrics for academic clinical trial performance that permit future comparisons. Conclusions: ECLIM-SEHOP facilitates Spanish children and adolescents diagnosed with cancer and blood disorders to access state-of-the-art diagnostic and therapeutic strategies

Acquisition of motion events in L2 Spanish by German, French and Italian speakers

This article explores the second language acquisition of motion events, with particular regard to cross-linguistic influence between first and second languages. Oral narratives in Spanish as a second language by native speakers of French, German and Italian are compared, together with narratives by native Spanish speakers. Previous analysis on the expression of motion events in these languages showed that Romance languages do not always follow the same pattern; for example, Italian tends to express the component of Path more frequently than French and Spanish. The results of the present study highlight evidence of intra-typological differences, even between languages that are genetically very close. These differences seem to lead speakers to produce cases of conceptual transfer into their second language, Spanish, even when their first language is another Romance language