Modelo numérico con interacción corte-flexión en elementos de concreto armado

This paper presents a numerical model based on damage theory and fracture mechanics to simulate the cyclic behavior of reinforced concrete elements subjected to high shear forces and / or bending. Numerous tests were conducted on beams, columns and shear walls under cyclic loading. To establish the validity of the proposed model, are simulated the behavior curves of the specimens tested. The analytical results generally show a good correlation with experimental results. The proposed finite element was also validated by a test on a beam with double shear span (short-slender) subject cyclical lateral load. An adequate correlation was obtained between the numerical and experimental valuesEn este trabajo se propone un modelo numérico basado en la teoría del daño y de la mecánica de la fractura para simular el comportamiento histerético de elementos de concreto armado sometidos a altas fuerzas de corte y/o flexión. Se realizaron ensayos de comportamiento en vigas, columnas y muros sometidos a carga lateral cíclica reversible. Para establecer la validez del modelo propuesto, se simularon las curvas de comportamiento de los espécimenes ensayados experimentalmente. Los resultados analíticos, en general, muestran una buena correlación con los resultados experimentales. El modelo de comportamiento propuesto también fue validado con un ensayo de una viga con doble claro de cortante (corta-esbelta) obteniéndose una adecuada correlación entre los valores numéricos y experimentales

Práctica basada en evidencia. Propiedades psicométricas de un cuestionario para su medición

Objective: The questionnaire developed in the U.S by Jette et al. is used as a screening tool to estimate the attitudes, beliefs, knowledge and behaviors toward evidence-based practice (EBP). This instrument was adapted and validated in the Spanish language by Guerra et al., but lacking validity studies in the Hispanic population. This research has aimed to estimate the psychometric properties as a way to obtain evidence on the validity of the instruments for the use proposed. Method: The sample was made up of 1,064 Physiotherapists in Colombia who completed the on-line version of the questionnaire. Its reliability and reproducibility were estimated with Cronbach's alpha procedure, the test-retest with Lin' correlation coefficient and Cohen's kappa index, respectively. An exploratory factor analysis was used to analyze the factorial structure. Results: The questionnaire has shown global high internal consistency, moderate temporal stability, acceptable reproducibility, and construct validity appropriate. Exploratory factorial analysis identified two factors that account for 37.953% of the variance. Conclusions: The results obtained in this study support the use of this questionnaire for this type of sample from the viewpoint of reliability and factor structure. However, further studies are needed to provide evidence of validity based on the relationship with other variables to determine its usefulness as a questionnaire to evaluate the EBP. © 2013 Asociación Española de Fisioterapeutas

Práctica basada en evidencia. Propiedades psicométricas de un cuestionario para su medición

Objective: The questionnaire developed in the U.S by Jette et al. is used as a screening tool to estimate the attitudes, beliefs, knowledge and behaviors toward evidence-based practice (EBP). This instrument was adapted and validated in the Spanish language by Guerra et al., but lacking validity studies in the Hispanic population. This research has aimed to estimate the psychometric properties as a way to obtain evidence on the validity of the instruments for the use proposed. Method: The sample was made up of 1,064 Physiotherapists in Colombia who completed the on-line version of the questionnaire. Its reliability and reproducibility were estimated with Cronbach's alpha procedure, the test-retest with Lin' correlation coefficient and Cohen's kappa index, respectively. An exploratory factor analysis was used to analyze the factorial structure. Results: The questionnaire has shown global high internal consistency, moderate temporal stability, acceptable reproducibility, and construct validity appropriate. Exploratory factorial analysis identified two factors that account for 37.953% of the variance. Conclusions: The results obtained in this study support the use of this questionnaire for this type of sample from the viewpoint of reliability and factor structure. However, further studies are needed to provide evidence of validity based on the relationship with other variables to determine its usefulness as a questionnaire to evaluate the EBP. © 2013 Asociación Española de Fisioterapeutas

Barreras para la implementación de la práctica basada en la evidencia (EBP): una encuesta de fisioterapeutas colombianos y españoles

In countries such as Australia, Spain, United States, Colombia, and United Kingdom, the use, teaching and evaluation of ‘evidence-based physical therapy’ (EBPT) in clinical practice has been recently included in educational curriculum. As consequence, PT have support the EBPT, proposing a series of initiatives designed to generate, evaluate and disseminate research, and to implement these results in practice. Despite most research has focused on the use of evidence, including a critical review of studies and scientific literature in clinical practice, if it is desiderate that the use of EBP becomes a reality, it is important to examine the numerous perceived barriers to using research in clinical settings, despite the paucity of studies in this topic. This is especially true for professions such as physiotherapy that has a small research base and few resources compared with other professions. Typically, barriers are context-dependent; therefore, the implementation of strategies should be tailored according to the context and the specific barriers identified. The most commonly reported barrier among PT is the limited time, which constrains the identification and interpretation of research evidence, as well as the ability to apply research findings in clinical practice

Práctica basada en evidencia. Propiedades psicométricas de un cuestionario para su medición

20 páginasObjective: The questionnaire developed in the U.S by Jette et al. is used as a screening to olto estimate the attitudes, beliefs, knowledge and behaviors toward evidence-based practice(EBP). This instrument was adapted and validated in the Spanish language by Guerra et al., but lacking validity studies in the Hispanic population. This research has aimed to estimate the psychometric properties as a way to obtain evidence on the validity of the instruments for the use proposed. Method: The sample was made up of 1,064 Physiotherapists in Colombia who completed the on-line version of the questionnaire. Its reliability and reproducibility were estimated with Cronbach s alpha procedure, the test-retest with Lin correlation coefficient and Cohen s kappaindex, respectively. An exploratory factor analysis was used to analyze the factorial structure. Results: The questionnaire has shown global high internal consistency, moderate temporal stability, acceptable reproducibility, and construct validity appropriate. Exploratory factorial analysis identified two factors that account for 37.953% of the variance. Conclusions: The results obtained in this study support the use of this questionnaire for this type of sample from the viewpoint of reliability and factor structure. However, further studies are needed to provide evidence of validity based on the relationship with other variables to determine its usefulness as a questionnaire to evaluate the EBPObjetivo: El cuestionario desarrollado en EE. UU. por Jette et al. se emplea como herramienta para estimar las actitudes, las creencias, los conocimientos y los comportamientos hacia la práctica basada en la evidencia (PBE). Este instrumento fue adaptado y validado en lengua española por Guerra et al., pero carece de estudios de validez en población hispana. El objetivo de esta investigación fue estimar las propiedades psicométricas, como forma de obtener evidencias de validez del instrumento para el uso propuesto. Método: La muestra se compone de 1.064 fisioterapeutas de Colombia y que completaron la versión on-line del cuestionario. La fiabilidad y la reproducibilidad fueron estimadas mediante el procedimiento alfa de Cronbach, prueba-reprueba con el coeficiente de correlación intra-clase de Lin y el índice de kappa de Cohen, respectivamente. Se aplicó un análisis factorial exploratorio para analizar la estructura factorial. Resultados: El cuestionario ha mostrado a nivel global alta consistencia interna, moderada estabilidad temporal, aceptable reproducibilidad, apropiada validez de constructo y adecuada bondad de ajuste a una estructura unidimensional. El análisis factorial exploratorio identificó 2 factores que explican el 37,953% de la varianza. Conclusiones: Los resultados obtenidos en este cuestionario avalan la utilización de este instrumento con este tipo de muestra, desde el punto de vista de la fiabilidad y la estructura factorial. No obstante, es necesario realizar nuevos estudios que aporten evidencias de validez basadas en la relación con otras variables, para determinar su utilidad como instrumento de prueba que evalúe la PB

Registro de linfomas cutáneos primarios (RELCP) de la AEDV: datos tras 5 años de funcionamiento

Resumen: Antecedentes y objetivos: Los linfomas cutáneos primarios (LCP) son un conjunto de entidades poco frecuentes. En febrero del 2018 se describieron los resultados del primer año de funcionamiento del Registro de linfomas cutáneos primarios de la AEDV. En el presente trabajo actualizamos los resultados tras 5 años de funcionamiento. Pacientes y métodos: Registro de enfermedad de pacientes con LCP. Se recogieron datos prospectivamente de los pacientes, incluyendo diagnóstico, tratamientos, pruebas realizadas y estado actual del paciente. Se realizó un análisis descriptivo. Resultados: En diciembre del 2021 se había incluido a un total de 2020 pacientes en el Registro, pertenecientes a 33 hospitales españoles. El 59% fueron hombres, la edad media fue de 62,2 años. Se agruparon en 4 grandes grupos diagnósticos: micosis fungoide/síndrome de Sézary (1.112, 55%), LCP de células B (547, 27,1%), trastornos linfoproliferativos de células T CD30+ (222, 11%) y otros linfomas T (116, 5,8%). La mayoría presentó estadio T1, encontrándose actualmente casi el 75% en remisión completa (43,5%) o enfermedad estable (EE; 27%). Los tratamientos más usados fueron corticoides tópicos (1.369, 67,8%), fototerapia (890, 44,1%), cirugía (412, 20,4%) y radioterapia (384, 19%). Conclusión: Las características del paciente con LCP en España no difieren de otras series. El mayor tamaño del registro permite precisar mejor los datos con respecto a los resultados del primer año. Este registro facilita al grupo de linfomas de la AEDV realizar investigación clínica, surgiendo ya trabajos publicados de dicho registro. Abstract: Background and objective: Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. Patients and methods: RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. Results: Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30 + lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). Conclusion: The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data

[Translated article] Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV): Data for the First 5 Years

Background and objective: Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. Patients and methods: RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. Results: Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30+ lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). Conclusion: The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data. Resumen: Antecedentes y objetivos: Los linfomas cutáneos primarios (LCP) son un conjunto de entidades poco frecuentes. En febrero del 2018 se describieron los resultados del primer año de funcionamiento del Registro de linfomas cutáneos primarios de la AEDV. En el presente trabajo actualizamos los resultados tras 5 años de funcionamiento. Pacientes y métodos: Registro de enfermedad de pacientes con LCP. Se recogieron datos prospectivamente de los pacientes, incluyendo diagnóstico, tratamientos, pruebas realizadas y estado actual del paciente. Se realizó un análisis descriptivo. Resultados: En diciembre del 2021 se había incluido a un total de 2.020 pacientes en el Registro, pertenecientes a 33 hospitales españoles. El 59% fueron hombres, y la edad media fue de 62,2 años. Se agruparon en 4 grandes grupos diagnósticos: micosis fungoide/síndrome de Sézary (1.112 [55%]), LCP de células B (547 [27,1%]), trastornos linfoproliferativos de células T CD30+ (222 [11%]) y otros linfomas T (116 [5,8%]). La mayoría presentó estadio T1, encontrándose actualmente casi el 75% en remisión completa (43,5%) o enfermedad estable (EE: 27%). Los tratamientos más usados fueron corticoides tópicos (1.369 [67,8%]), fototerapia (890 [44,1%]), cirugía (412 [20,4%]) y radioterapia (384 [19%]). Conclusión: Las características del paciente con LCP en España no difieren de otras series. El mayor tamaño del registro permite precisar mejor los datos con respecto a los resultados del primer año. Este registro facilita al grupo de linfomas de la AEDV realizar investigación clínica, surgiendo ya trabajos publicados de dicho registro

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results: A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion: Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)