Current features of infective endocarditis in elderly patients: results of the International Collaboration on Endocarditis Prospective Cohort Study.

BACKGROUND: Elderly patients are emerging as a population at high risk for infective endocarditis (IE). However, adequately sized prospective studies on the features of IE in elderly patients are lacking. METHODS: In this multinational, prospective, observational cohort study within the International Collaboration on Endocarditis, 2759 consecutive patients were enrolled from June 15, 2000, to December 1, 2005; 1056 patients with IE 65 years or older were compared with 1703 patients younger than 65 years. Risk factors, predisposing conditions, origin, clinical features, course, and outcome of IE were comprehensively analyzed. RESULTS: Elderly patients reported more frequently a hospitalization or an invasive procedure before IE onset. Diabetes mellitus and genitourinary and gastrointestinal cancer were the major predisposing conditions. Blood culture yield was higher among elderly patients with IE. The leading causative organism was Staphylococcus aureus, with a higher rate of methicillin resistance. Streptococcus bovis and enterococci were also significantly more prevalent. The clinical presentation of elderly patients with IE was remarkable for lower rates of embolism, immune-mediated phenomena, or septic complications. At both echocardiography and surgery, fewer vegetations and more abscesses were found, and the gain in the diagnostic yield of transesophageal echocardiography was significantly larger. Significantly fewer elderly patients underwent cardiac surgery (38.9% vs 53.5%; P < .001). Elderly patients with IE showed a higher rate of in-hospital death (24.9% vs 12.8%; P < .001), and age older than 65 years was an independent predictor of mortality. CONCLUSIONS: In this large prospective study, increasing age emerges as a major determinant of the clinical characteristics of IE. Lower rates of surgical treatment and high mortality are the most prominent features of elderly patients with IE. Efforts should be made to prevent health care-associated acquisition and improve outcomes in this major subgroup of patients with IE.

Political justice, schooling and issues of group identity

This article explores issues associated with schooling and political justice. Such issues are understood in light of the contention surrounding howWestern schooling contexts might best represent marginalised groups—in ways that accord them a political voice. The significance of group identity politics is explored drawing on international debates associated with ethnically segregated schooling. A postcolonial theorising of group identity highlights the ways in which segregated schooling can both support and undermine politically just representation for marginalised students. This theorising draws attention to the problematic notion of voice in linking representation to identity in reductionist ways. The arguments presented point to the significance of people and their politics, rather than their membership to a particular identity group, in pursuing equity for marginalised groups. The article argues the imperative of understanding group identity as an aspect of negotiated social practice that can be drawn on in strategic and critical ways to address matters of political injustice.

Urban heritage, development and sustainability: international frameworks, national and local governance

More than half of the world’s population now live in urban areas, and cities provide the setting for contemporary challenges such as population growth, mass tourism and unequal access to socio-economic opportunities. Urban Heritage, Development and Sustainability examines the impact of these issues on urban heritage, considering innovative approaches to managing developmental pressures and focusing on how taking an ethical, inclusive and holistic approach to urban planning and heritage conservation may create a stronger basis for the sustainable growth of cities in the future.This volume is a timely analysis of current theories and practises in urban heritage, with particular reference to the conflict between, and potential reconciliation of, conservation and development goals. A global range of case studies detail a number of distinct practical approaches to heritage on international, national and local scales. Chapters reveal the disjunctions between international frameworks and national implementation and assess how internationally agreed concepts can be misused to justify unsustainable practices or to further economic globalisation and political nationalism. The exclusion of many local communities from development policies, and the subsequent erosion of their cultural heritage, is also discussed, with the collection emphasising the importance of ‘grass roots’ heritage and exploring more inclusive and culturally responsive conservation strategies. Contributions from an international group of authors, including practitioners as well as leading academics, deliver a broad and balanced coverage of this topic. Addressing the interests of both urban planners and heritage specialists, Urban Heritage, Development and Sustainability is an important addition to the field that will encourage further discourse.

Implementing the international benchmarking labour productivity theoretical model

Purpose – Building upon the results of a critical review of previous studies, the purpose of this paper is to present a framework to enhance the reliability of the theoretical model for international benchmarking of labour productivity (TMIBLP) method for construction project activities. The next part of the paper presents the results of implementing the proposed framework for construction activities in the Iranian construction industry. Design/methodology/approach – This paper draws upon a critical review of the literature to highlight the drawbacks of the previous studies concerning implementing TMIBLP within the construction industry. Identifying these shortcomings, the authors propose a framework for construction projects, which presents the procedure for deploying TMIBLP for construction activities in a reliable manner. The final section of the paper demonstrates the empirical implementation of the proposed framework within the Iranian construction industry. Findings – The primary contributions of the paper include: identifying the drawbacks of previous studies within the construction context, the framework that would lead construction managers towards more reliable implementation of benchmarking for construction projects, and determining the baseline of erecting steel structures in a developing country. Practical implications – A practical implementation of the TMIBLP method was presented to address the lack of research in Iran and to show the feasibility of using the framework developed. The authors investigated the daily labour productivity for the activity of structural steel erection for six projects in Tehran in order to determine the values of the baseline productivity for each project. Accordingly, the disruption index, performance ratio and project management index as the project benchmarks were calculated for all six projects. Originality/value – Underlining the necessity of implementing methods such as TMIBLP, this study outlines the outcomes of the first study on the benchmarking of construction activities deploying the proposed framework and using the data on erecting steel structures from six construction projects in Iran. The discussions provide guidelines for construction project managers regarding benchmarking labour productivity. The paper concludes with suggestions for future research opportunities.

Voices of dissent: Unpacking Vietnamese international student experience

Purpose – This study examines Vietnamese international students’ experiences with thecampus learning environment by analysing differences in staff and student perceptions.Design/methodology/approach – Two focus groups (N = 12) and ten (10) in-depthinterviews were conducted with Vietnamese students and four (4) in-depth interviews withthe university staff (totalling 26).Findings – The findings show a greater divergence of views between students and staff onteaching and learning than English language proficiency and student support services.These key differences were influenced by students’ prior expectations of their learningenvironment.Research limitations/implications – This study is limited to one group of internationalstudents and to one Australian university.Practical implications – The academics and administrators must have a goodunderstanding of international students’ learning backgrounds and expectations to enhancetheir positive experience; Appropriate teaching skills and practices are essential foracademics to meet the current needs of students. More effective training for internationalstudents to understand the multicultural nature of Australia is also essential.Originality/value – This study contributes to the literature by identifying the experienceof Vietnamese international students in a western university, which is, a relatively underresearchednationality compared to other Asian nationalities such as Chinese and Indian.

The theory of complexity adapted to international relations: the behaviour of the visegrad-ukraine complex adaptive system since November 2013

La teoría de la complejidad, propia del estudio de fenómenos relativos a las ciencias naturales, se muestra como un marco alternativo para comprender los eventos emergentes que surgen en el sistema internacional. Esta monografía correlaciona el lenguaje de la complejidad con las relaciones internacionales, enfocándose en la relación Visegrad—Ucrania, ya que ha sido escenario de una serie de eventos emergentes e inesperados desde las protestas civiles de noviembre de 2013 en Kiev. El sistema complejo que existe entre el Grupo Visegrad y Ucrania se ve , desde entonces, en la necesidad de adaptarse ante los recurrentes eventos emergentes y de auto organizarse. De ese modo, podrá comportarse en concordancia con escenarios impredecibles, particularmente en lo relacionado con sus interacciones energéticas y sus interconexiones políticas.

Ideación suicida y desesperanza en pacientes con cáncer

El objetivo de la presente investigación fue identificar la relación entre ideación suicida y desesperanza en 160 pacientes con cáncer. La ideación suicida se midió a través de dos ítems de una entrevista semiestructurada, la escala de ideación suicida (ISS), el ítem 9 del inventario de depresión de Beck (BDI-IA). La desesperanza se midió con la escala de desesperanza de Beck (BHS). Los resultados obtenidos indicaron una relación significativa (p=.000) entre ideación suicida y desesperanza; una prevalencia de ideación suicida en los pacientes con cáncer entre 4.4% y 13.8% y de riesgo de suicidio entre 5.6% y 30.6%; y algún grado de desesperanza en 31.9 % de los participantes. De acuerdo con lo anterior, se confirma que existe relación entre la desesperanza y la ideación suicida en pacientes oncológicos adultos. Adicionalmente, que estas variables están presentes en los pacientes y que ameritan atención en la intervención interdisciplinaria.

Validity and reliability of the international fItness scale (IFIS) in a population-based sample of schoolchildren in Bogota, Colombia: The FUPRECOL study

The International FItness Scale (IFIS) is a self-reported measure of physical fitness that could easily. This scale has been validated in children, adolescents, and young adults; however, it is unknown whether the IFIS represents a valid and reliable estimate of physical fitness in Latino-American youth population. In the present study we aimed to examine the validity and reliability of the IFIS on a population-based sample of schoolchildren in Bogota, Colombia. Participants were 1,875 Colombian youth (56.2% girls) aged 9 to 17.9 years old. We measured adiposity markers (body fat, waist-to-height ratio, skinfold thicknesses and BMI), blood pressure, lipids profile, fasting glucose, and physical fitness level (self reported and measured). Also, a validated cardiometabolic risk index was used. An age- and sex-matched sample of 229 Schoolchildren originally not included in the study sample fulfilled IFIS twice for reliability purposes. Our data suggest that both measured and self-reported overall fitness were associated inversely with adiposity indicators and a cardiometabolic risk score. Overall, schoolchildren who self-reported “good” and “very good” fitness had better measured fitness than those who reported “very poor” and “poor” fitness (all p<0.001). Test–retest reliability of IFIS items was also good, with an average weighted Kappa of 0.811. Therefore, our findings suggest that self-reported fitness, as assessed by IFIS, is a valid, reliable, and health-related measure, and it can be a good alternative for future use in large studies with Latin-schoolchildren from Colombia.

Petrofac International Limited: el mercadeo interno, una estrategia efectiva en el manejo de personal

Como futuros administrados es importante recordar que nuestra función no será únicamente crear una empresa y generar constantemente ingresos. Esto es una de tantas tareas que tiene una persona que se encamina por crear o ser parte de una empresa, sea grande o pequeña siempre existirán variables que con los años se han convertido más y más indispensables en los procesos de este recorrido. El tema principal de nuestro estudio de caso es entender el concepto del endomarketing o como muchos lo conocen marketing interno; en pocas palabras es algo que por años se ha visto su efectividad en la productividad y satisfacción de los empleados. Google es una de las multinacionales más grandes del mundo, que el ultimo reconocimiento fue por parte de uno de los ranking más influyentes “The World’s Billionaries” ocupando como el CEO de la compañía Larry Page el puesto #12 , que por años ha sabido invertir en su recurso más importante que son sus empleados. En una entrevista con la revista Fortune, Larry exclama que “es importante que la empresa sea una familia, que las personas sientan que son parte de la empresa, y que la empresa es como una familia para ellos. Cuando se trata a las personas de esa manera, se obtiene una mejor productividad”. Con este pequeño ejemplo e idea de cómo una de las marcas más influyentes en el mundo ha fortalecido su mejor recurso por años el cual le ha remunerado con el éxito que tiene hoy en día. Entonces es como el mercadeo interno o endomarketing siendo uno de los conceptos tratados en el mercadeo en general hoy en día, logrando meterse como un modelo de negocio en la mayoría de empresas que existen hoy. Este es uno de los motivos que nos motivó para desarrollar este estudio de caso que verán a continuación, el cual se basa en la investigación y análisis de variables que comprenden a la empresa Petrofac, y si bien ha sabido implementar el concepto en sus procesos diarios. El estudio de caso describe como a través de los años ha sabido implementar con éxito la herramienta de evaluación y análisis del mercado interno a los empleados que constituyen hoy en día Petrofac International Limited. Abarcaremos primero con los objetivos del estudio, seguido del inicio y crecimiento de la empresa en los últimos años, en que países tiene presencia y cuáles son sus proyectos más importantes hoy en día. El estudio de caso será implementado por un tipo de investigación descriptiva, que con la recopilación de suficiente información tanto cuantitativa como cualitativa nos ira fortaleciendo la hipótesis principal, usaremos datos estadísticos que serán recopilados de encuestas, entrevistas y focus group. Al final con el análisis y a las conclusiones que lleguemos se busca demostrar el impacto positivo que ha tenido los empleados de diferentes países y de diferentes culturas que poco a poco han influenciado a la empresa para alcanzar el éxito que ha logrado hasta ahora, y de la misma forma como la empresa ha influenciado en cada una de las vidas de estas personas sin importar el lugar en el que estén laborando, siempre la empresa busca que se sientan parte de ella. Como resultados generales, se obtienen argumentos que sustentan que la implementación del mercadeo interno le permite a la empresa generar ventajas competitivas y dinámicas, que son desarrolladas internamente para un futuro reflejarlas ante los clientes externos. El estudio permitió concluir que el mercadeo interno debe ser una estrategia de comunicación dentro de una empresa convirtiéndose de primera necesidad para la compañía, pues los beneficios que genera son cada vez más necesarios para cada área que abarca el negocio.

Aproximaciones a mindfulness en la psicología contemporánea

Este trabajo es una revisión de literatura que abarca una selección de artículos disponibles en bases de datos especializadas y publicados en el periodo comprendido entre los años 2006 a 2016 para artículos científicos y entre los años 2000 a 2016 para libros. En total se revisaron: 1 tesis doctoral, 1 tesis magistral, 111 artículos y 9 libros o capítulos de libros. Se presentan diversas definiciones de mindfulness y formas de conceptualizarla, sus mecanismos de acción, sus enfoques psicoterapéuticos predominantes, los efectos de su práctica estable, sus principales campos de acción y la importancia de la formación de los docentes que imparten la práctica. Finalmente se presentan algunas conclusiones acerca del diálogo entre la literatura psicológica sobre mindfulness y algunas de las concepciones de la tradición budista en torno a la meditación.

Small states and the promotion of their foreign policy agenda in the international scenario: Trinidad and Tobago and the Kyoto Protocol

Este estudio de caso busca identificar los elementos del portafolio de política exterior de Trinidad y Tobago que le permitieron promover exitosamente sus intereses en el Protocolo de Kioto. Al hacer esto, este texto analizará las limitaciones de Trinidad y Tobago en términos de vulnerabilidades de localización, burocracia y recursos. Posteriormente, una revisión del portafolio de política exterior de este Estado ilustrará el uso de estrategias de creación de capacidades y de organización como lo son el contacto con actores institucionales y no gubernamentales, la formación de coaliciones y estrategias argumentativas, entre otras. Finalmente, este artículo concluirá que dichas acciones permitieron la promoción de la agenda de política exterior de Trinidad y Tobago a través de la creación de hojas de ruta y la coordinación de la incertidumbre con el Protocolo de Kioto. Para hacer esto, este trabajo se concentrará en examinar conceptos como vulnerabilidad y priorización, asimismo contrastando diferentes artículos académicos en la materia junto con documentos oficiales de Trinidad y Tobago.

Total Quality Management and Corporate Social Responsibility. Literature review. The case of Nabeiro Delta Cafés Group

The relationship between the themes of Total Quality Management (TQM) and Social Responsibility (CSR) through the concepts, approaches and models of excellence is a reality of sustainable and stable companies. Being organizations, people, act correctly and rightly do in society go through a quality management and social responsibility thereof. It is based on these two philosophies (Total Quality Management and Corporate Social Responsibility), which developed this literature review work, essentially based on a relational analysis in two papers, namely: "TQM and CSR Nexus" by Ghobadian et al. (2007) and "The Corporate Social Responsibility Audit Within the Quality Management Framework," de Kok et al. (2001) and applied to an organizational situation in concrete: the Nabeiro Delta Cafés Group - SGPS, SA.

MAGGnet: an international network to foster mitigation of agricultural greenhouse gases.

Research networks provide a framework for review, synthesis and systematic testing of theories by multiple scientists across international borders critical for addressing global-scale issues. In 2012, a GHG research network referred to as MAGGnet (Managing Agricultural Greenhouse Gases Network) was established within the Croplands Research Group of the Global Research Alliance on Agricultural Greenhouse Gases (GRA). With involvement from 46 alliance member countries, MAGGnet seeks to provide a platform for the inventory and analysis of agricultural GHG mitigation research throughout the world. To date, metadata from 315 experimental studies in 20 countries have been compiled using a standardized spreadsheet. Most studies were completed (74%) and conducted within a 1-3-year duration (68%). Soil carbon and nitrous oxide emissions were measured in over 80% of the studies. Among plant variables, grain yield was assessed across studies most frequently (56%), followed by stover (35%) and root (9%) biomass. MAGGnet has contributed to modeling efforts and has spurred other research groups in the GRA to collect experimental site metadata using an adapted spreadsheet. With continued growth and investment, MAGGnet will leverage limited-resource investments by any one country to produce an inclusive, globally shared meta-database focused on the science of GHG mitigation.