Suboptimal Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients With Myocardial Infarction

Background: The incidence of cardiovascular events in HIV patients has fallen. Methods: We identified 81 patients with a history of coronary events from 2 hospitals in Spain to evaluate management of CVRF before and after the event. Results: The prevalence of coronary events was 2.15%. At the time of the coronary event, CVRF were highly prevalent. Decrease in total cholesterol (P=0.025) and LDLc(P=0.004) was observed. LDLc and HDLc were determined and the percentage of patients with LDLc &100 mg/dL remained stable at the last visit. Conclusions: The prevalence of coronary disease in our cohort was low. Although CVRF were highly.

Environmental factors giving rise to variations in national management accounting practice

Comparative national management accounting is the least developed aspect in the field of international accounting. Only during the second half of the 1990's some comparisons of national managementaccounting practice have appeared published but only at theregional level. In this paper a range of factors that give rise to variations in national management accounting practice are postulated. We support this list with examples from a range of analyses of national management accounting practices, drawing particularly on the work of Lizcano (1996) and Bhimani (1996).Finally, twelve key factors are identified as influencing an individual country's approach to management accounting.

Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

There are conflicting data on the prevalence of coronary events and the quality of the management of modifiable cardiovascular risk factors (CVRF) inHIV-infected patients. Methods.We performed a retrospective descriptive study to determine the prevalence of coronary events and to evaluate the management of CVRF in a Mediterranean cohort of 3760 HIV-1-infected patients from April 1983 through June 2011. Results.We identified 81 patients with a history of a coronary event (prevalence 2.15%); 83% of them suffered an acute myocardial infarction. At the time of the coronary event, CVRF were highly prevalent (60.5% hypertension, 48% dyslipidemia, and 16% diabetes mellitus).OtherCVRF, such as smoking, hypertension, lack of exercise, and body mass index, were not routinely assessed. After the coronary event, a significant decrease in total cholesterol ( � = 0.025) and LDLcholesterol ( � = 0.004) was observed. However, the percentage of patients whomaintained LDL-cholesterol > 100mg/dL remained stable (from 46% to 41%, � = 0.103). Patients using protease inhibitors associated with a favorable lipid profile increased over time ( � = 0.028). Conclusions.The prevalence of coronary events in our cohort is low. CVRF prevalence is high and theirmanagement is far from optimal. More aggressive interventions should be implemented to diminish cardiovascular risk in HIV-infected patients.

Access as a motivational device: implications for human resource management

This paper analyzes the employment relationship on the basis of the notion of access. We argue that the degree of access provided by a job is an incentive to activate the employee’s self-actualization needs. We investigate the effect of access on the workers’ performance through an agency model and provide a number of propositions with practical implications for personnel policies. Our results are consistent with the intuition emerged from the real business practice as well as with many of the arguments on the substitutive role between monetary and non-monetary incentives frequently reported in the literature.

Entorns col•laboratius virtuals asíncrons basats en Web i enfocats en la gestió del coneixement = Web-based Asynchronous Collaborative Environments Focused on Knowledge Management

Report for the scientific sojourn at the University of California at Berkeley, USA, from september 2007 until july 2008. Communities of Learning Practice is an innovative paradigm focused on providing appropriate technological support to both formal and especially informal learning groups who are chiefly formed by non-technical people and who lack of the necessary resources to acquire such systems. Typically, students who are often separated by geography and/or time have the need to meet each other after classes in small study groups to carry out specific learning activities assigned during the formal learning process. However, the lack of suitable and available groupware applications makes it difficult for these groups of learners to collaborate and achieve their specific learning goals. In addition, the lack of democratic decision-making mechanisms is a main handicap to substitute the central authority of knowledge presented in formal learning.

Earnings management and audit adjustments: An empirical study of IBEX 35 constituents

Doubts about the reliability of a company's qualitative financial disclosure increase market participant expectations from the auditor's report. The auditing process is supposed to serve as a monitoring device that reduces management incentives to manipulate reported earnings. Empirical research confirms that it could be an efficient device under some circumstancesand recognizes that our estimates of the informativeness of audit reports are unavoidably biased (e.g., because of a client's anticipation of the auditing process). This empirical study supports the significant role of auditors in the financial market, in particular in the prevention of earnings management practice. We focus on earnings misstatements, which auditors correct with anadjustment, using a sample of past and current constituents of the benchmark market index in Spain, IBEX 35, and manually collected audit adjustments reported over the 1997-2004 period (42 companies, 336 annual reports, 75 earnings misstatements). Our findings confirm that companies more often overstate than understate their earnings. An investor may foresee earningsmisreporting, as manipulators have a similar profile (e.g., more leveraged and with lower sales). However, he may receive valuable information from the audit adjustment on the size of earnings misstatement, which can be significantly large (i.e., material in almost all cases). We suggest that the magnitude of an audit adjustment depends, other things constant, on annual revenues and free cash levels. We also examine how the audit adjustment relates to the observed market price, trading volume and stock returns. Our findings are that earnings manipulators have a lower price and larger trading volume compared to their rivals. Their returns are positively associated with the magnitude of earnings misreporting, which is not consistent with the possible pricing of audit information.

On bounds for network revenue management

The Network Revenue Management problem can be formulated as a stochastic dynamic programming problem (DP or the\optimal" solution V *) whose exact solution is computationally intractable. Consequently, a number of heuristics have been proposed in the literature, the most popular of which are the deterministic linear programming (DLP) model, and a simulation based method, the randomized linear programming (RLP) model. Both methods give upper bounds on the optimal solution value (DLP and PHLP respectively). These bounds are used to provide control values that can be used in practice to make accept/deny decisions for booking requests. Recently Adelman [1] and Topaloglu [18] have proposed alternate upper bounds, the affine relaxation (AR) bound and the Lagrangian relaxation (LR) bound respectively, and showed that their bounds are tighter than the DLP bound. Tight bounds are of great interest as it appears from empirical studies and practical experience that models that give tighter bounds also lead to better controls (better in the sense that they lead to more revenue). In this paper we give tightened versions of three bounds, calling themsAR (strong Affine Relaxation), sLR (strong Lagrangian Relaxation) and sPHLP (strong Perfect Hindsight LP), and show relations between them. Speciffically, we show that the sPHLP bound is tighter than sLR bound and sAR bound is tighter than the LR bound. The techniques for deriving the sLR and sPHLP bounds can potentially be applied to other instances of weakly-coupled dynamic programming.

The impact of Economics on health policy and management in Spain

BackgroundDespite the intrinsic value of scientific disciplines, such as Economics, it is appropriate to gauge the impact of its applications on social welfare, or at least Health Economics (HE) case- its influence on health policy and management.MethodsThe three relevant features of knowledge (production, diffusion and application) are analyzed, more from an emic perspective the one used in Anthropology relying on the experience of the members of a culture- than from an etic approach seated on material descriptions and dubious statistics.ResultsThe soundness of the principles and results of HE depends on its disciplinary foundations,whereas its relevance than does not imply translation into practice- is more linked with the problems studied. Important contributions from Economics to the health sphere are recorded.HE in Spain ranks seventh in the world despite the relatively minor HE contents of its clinical and health services research journals.HE has in Spain more presence than influence, having failed to impregnate sufficiently thedaily events.ConclusionsHE knowledge required by a politician, a health manager or a clinician is rather limited; the main impact of HE could be to develop their intuition and awareness.

EULAR recommendations for the management of large-vessel vasculitis.

Objectives: To develop European League Against Rheumatism (EULAR) recommendations for the management of large vessel vasculitis. Methods: An expert group (10 rheumatologists, 3 nephrologists, 2 immunolgists, 2 internists representing 8 European countries and the USA, a clinical epidemiologist and a representative from a drug regulatory agency) identified 10 topics for a systematic literature search through a modified Delphi technique. In accordance with standardised EULAR operating procedures, recommendations were derived for the management of large vessel vasculitis. In the absence of evidence, recommendations were formulated on the basis of a consensus opinion. Results: Seven recommendations were made relating to the assessment, investigation and treatment of patients with large vessel vasculitis. The strength of recommendations was restricted by the low level of evidence and EULAR standardised operating procedures. Conclusions: On the basis of evidence and expert consensus, management recommendations for large vessel vasculitis have been formulated and are commended for use in everyday clinical practice.

EULAR recommendations for the management of primary small and medium vessel vasculitis.

Objectives: To develop European League Against Rheumatism (EULAR) recommendations for the management of small and medium vessel vasculitis. Methods: An expert group (consisting of 10 rheumatologists, 3 nephrologists, 2 immunologists, 2 internists representing 8 European countries and the USA, a clinical epidemiologist and a representative from a drug regulatory agency) identified 10 topics for a systematic literature search using a modified Delphi technique. In accordance with standardised EULAR operating procedures, recommendations were derived for the management of small and medium vessel vasculitis. In the absence of evidence, recommendations were formulated on the basis of a consensus opinion. Results: In all, 15 recommendations were made for the management of small and medium vessel vasculitis. The strength of recommendations was restricted by low quality of evidence and by EULAR standardised operating procedures. Conclusions: On the basis of evidence and expert consensus, recommendations have been made for the evaluation, investigation, treatment and monitoring of patients with small and medium vessel vasculitis for use in everyday clinical practice.

Good practice for dialogue and communication as strategic principle for policing political manifestations in Europe (GODIAC):field study handbook

This handbook describes the peer review methodology that was applied at the GODIAC project fi eld studies1. The peer review evaluation method as initiated by Otto Adang in the Netherlands and further developed in a European football context (Adang & Brown, 2008) involves experienced police offi cers cooperating with researchers to perform observational fi eld studies to identify good practices and learning points for public order management. The handbook builds on the GODIAC seminars and workshops, for the fi eld study members, which took place in September 2010, January 2012 and January 2013. The handbook has been discussed in the project group and in the steering committee. It is primarily written for the GODIAC fi eld study members as background material for understanding the fi eld study process and for clarifying the different responsibilities that enable active participation in the fi eld study. The handbook has been developed during the project period and incorporates learning points and developments of the peer review method. The handbook aims at promoting the use of fi eld studies for evaluation of policing major events.

Clinical management and burden of bipolar disorder: a multinational longitudinal study (WAVE-bd Study)

BACKGROUND: Studies in bipolar disorder (BD) to date are limited in their ability to provide a whole-disease perspective--their scope has generally been confined to a single disease phase and/or a specific treatment. Moreover, most clinical trials have focused on the manic phase of disease, and not on depression, which is associated with the greatest disease burden. There are few longitudinal studies covering both types of patients with BD (I and II) and the whole course of the disease, regardless of patients' symptomatology. Therefore, the Wide AmbispectiVE study of the clinical management and burden of Bipolar Disorder (WAVE-bd) (NCT01062607) aims to provide reliable information on the management of patients with BD in daily clinical practice. It also seeks to determine factors influencing clinical outcomes and resource use in relation to the management of BD. METHODS: WAVE-bd is a multinational, multicentre, non-interventional, longitudinal study. Approximately 3000 patients diagnosed with BD type I or II with at least one mood event in the preceding 12 months were recruited at centres in Austria, Belgium, Brazil, France, Germany, Portugal, Romania, Turkey, Ukraine and Venezuela. Site selection methodology aimed to provide a balanced cross-section of patients cared for by different types of providers of medical aid (e.g. academic hospitals, private practices) in each country. Target recruitment percentages were derived either from scientific publications or from expert panels in each participating country. The minimum follow-up period will be 12 months, with a maximum of 27 months, taking into account the retrospective and the prospective parts of the study. Data on demographics, diagnosis, medical history, clinical management, clinical and functional outcomes (CGI-BP and FAST scales), adherence to treatment (DAI-10 scale and Medication Possession Ratio), quality of life (EQ-5D scale), healthcare resources, and caregiver burden (BAS scale) will be collected. Descriptive analysis with common statistics will be performed. DISCUSSION: This study will provide detailed descriptions of the management of BD in different countries, particularly in terms of clinical outcomes and resources used. Thus, it should provide psychiatrists with reliable and up-to-date information about those factors associated with different management patterns of BD. TRIAL REGISTRATION NO: ClinicalTrials.gov: NCT01062607.

A Semantic wiki for quality management in software development projects

Quality management has become a strategic issue for organisations and is very valuable to produce quality software. However, quality management systems (QMS) are not easy to implement and maintain. The authors' experience shows the benefits of developing a QMS by first formalising it using semantic web ontologies and then putting them into practice through a semantic wiki. The QMS ontology that has been developed captures the core concepts of a traditional QMS and combines them with concepts coming from the MPIu'a development process model, which is geared towards obtaining usable and accessible software products. Then, the ontology semantics is directly put into play by a semantics-aware tool, the Semantic MediaWiki. The developed QMS tool is being used for 2 years by the GRIHO research group, where it has manages almost 50 software development projects taking into account the quality management issues. It has also been externally audited by a quality certification organisation. Its users are very satisfied with their daily work with the tool, which manages all the documents created during project development and also allows them to collaborate, thanks to the wiki features.

A web ontologies framework for digital rights management

In order to improve the management of copyright in the Internet, known as Digital Rights Management, there is the need for a shared language for copyright representation. Current approaches are based on purely syntactic solutions, i.e. a grammar that defines a rights expression language. These languages are difficult to put into practise due to the lack of explicit semantics that facilitate its implementation. Moreover, they are simple from the legal point of view because they are intended just to model the usage licenses granted by content providers to end-users. Thus, they ignore the copyright framework that lies behind and the whole value chain from creators to end-users. Our proposal is to use a semantic approach based on semantic web ontologies. We detail the development of a copyright ontology in order to put this approach into practice. It models the copyright core concepts for creation, rights and the basic kinds of actions that operate on content. Altogether, it allows building a copyright framework for the complete value chain. The set of actions operating on content are our smaller building blocks in order to cope with the complexity of copyright value chains and statements and, at the same time, guarantee a high level of interoperability and evolvability. The resulting copyright modelling framework is flexible and complete enough to model many copyright scenarios, not just those related to the economic exploitation of content. The ontology also includes moral rights, so it is possible to model this kind of situations as it is shown in the included example model for a withdrawal scenario. Finally, the ontology design and the selection of tools result in a straightforward implementation. Description Logic reasoners are used for license checking and retrieval. Rights are modelled as classes of actions, action patterns are modelled also as classes and the same is done for concrete actions. Then, to check if some right or license grants an action is reduced to check for class subsumption, which is a direct functionality of these reasoners.