Статья посвящена основным историческим явлениям Византии VI в. Целью написания работы явилась задача: на основе анализа правления Юстиниана показать закономерные попытки власти достичь единства Церкви и Государства. Она позволила более убедительно поставить вопрос о влиянии исторических, политических, экономических, социальных, религиозных факторов на ход развития конкретного общества. Исследование базируется на широком круге источников и литературы (M.Maas, J.Barker, E.Jeffreys, G.Pfannmuller, G. Ostrogorsky, A. Knecht). Историю Византии VI в. и ее влияние на мир можно описывать в следующих взаимодействующих моделях: упорядочения, дисциплинарности и междисциплинарности. Современный уровень исследований по данной теме свидетельствует о том, что для разработки темы необходим синтезированный методологический подход. К примеру, вполне обоснован богословский метод канадского теолога Б.Лонергана (B.Lonergan. Method in Theology; P.Feyerabend. Against Method: Outline of an Anarchistic Theory of Knowledge). Тема интересна тем, что более широкая современная интерпретация источников по истории Византии VI в. может служить основанием для новых выводов. В качестве актуальной главной черты той эпохи следует выделить: соответствие политики юстинианского правления долгосрочным государственным интересам, гибкость и прагматизм, умение пользоваться сложившимися обстоятельствами, важность для правления государством собственного понимания церковных и государственных задач. Процесс исторического, философского, теологического понимания Византийской истории и глубокого осмысления наследия правления империей еще не завершен. Знания о Византии и ее влиянии на российскую историю формируют связь между прошлым и его современным пониманием на базе общей идентичности мотивов и идеалов в обществе. Автором в ходе исследования сделана попытка включиться в новое исследовательское поле в направлении использования комплексного представления о прошлом и способов его репрезентации. Важно было понять в социальном аспекте, каков был церковно-политический идеал Юстиниана, сравнение противоборствующих сторон, их внутренних общественных разногласий, потребностей к реформам, укрепление духовного стержня во взаимоотношениях Церкви и Государства. Ценность избранного исследования заключается в подтверждении вывода о требующих осмысления и уточнения вопросов, касающихся одного из важных этапов формирования Византийской империи, а также использования различных методологических подходов в исследовании. ; Article is devoted to the main historical events in Byzantium of VIth century. The aim of the study was writing task based on the analysis of Justinian show legitimate authorities are trying to achieve unity of Church and State. It allowed more convincingly put the question on the impact of historical, political, economic, social, and religious factors on the development of a particular society. The study is based on a wide range of sources and literature (M.Maas, J.Barker, E.Jeffreys, G.Pfannmuller, G. Ostrogorsky, A. Knecht). History of Byzantium VI and its impact on the world can be described in the following interacting models: ordering disciplinarity and interdisciplinarity. Modern level of research on this topic suggests that the development of the theme needs synthesized methodological approach. For example, Canadian theologian theological method B.Lonergan is well founded (B.Lonergan. Method in Theology; P.Feyerabend. Against Method: Outline of an Anarchistic Theory of Knowledge). The theme is interesting in that the broader modern interpretation of sources on the history of Byzantium VI can serve as a basis for the new conclusions. As the main features of the current era should be highlighted: compliance policy Justinian board long-term public interest, flexibility and pragmatism, the ability to use the prevailing circumstances, the importance for the state government's own understanding of church and state problems. Process of historical, philosophical, theological understanding of Byzantine history and deep understanding of heritage board empire is not yet complete. Knowledge of the Byzantine Empire and its impact on Russian history form the link between the past and the modern understanding a common identity based on motives and ideals in society. The author of the study attempted to engage in a new research field in the direction of an integrated knowledge of the past and how its representation. It was important to understand the social aspect of what was the church-political ideal of Justinian, the comparison of the opposing parties, their internal social differences, needs to reform, strengthening the spiritual core of the relationship between Church and state. Value of the study is to confirm the withdrawal of requiring understanding and clarify issues related to one of the most important stages in the formation of the Byzantine Empire, as well as the use of different methodological approaches to the study.
В центре статьи история вхождения в русскую поэтическую культуру Золотого века мирообраза Рима. Идеи «всемирной отзывчивости» русской литературы нашли свое отражение в освоении ментальных текстов других культур. В этом контексте ми-рообраз Рима приобрел репрезентативный смысл. Каждая эпоха русской общественной жизни 1800-1840-х гг., «идеи времени» выявляли в мирообразе Рима актуальное звучание. Актуализация римской истории, осмысление искусства эпохи Возрождения, открытие архитектурного и ландшафтного пространства, проникновение в мир римского карнавала каждый из этих этапов «прочтения» Рима соотносился с «формами времени» и определял своеобразие поэтического изображения. ; The paper describes the history of the formation of the world-image of Rome as a mental text, as a representation of the concept ''universal responsiveness'' of the Russian language culture in the Russian artistic consciousness, in the Russian poetry of the 1810-1840s. In the first part of the paper the basic parameters of the discovery of Rome as the symbol of this world-image. The Russian palindrome Rome-world captures the process of development of the Italian space as literary, virtual, dreamlike by the Russian poetry (poems by I. Kozlov, D. Venevitinov, N. Gogol). Woven of poetic cliches (Goethe, Byron, Madame de Stael), Zhukovsky's romantic philosophy of ''elevation of the soul'', the names of Raphael and Tasso, it was an all-romanticist topos of ''a wondrous dream'', a fantasy, a vision. Rome and Italy were seen as almost synonymous. Gradually, through the generalized image of Italy the Russian poetry of the 1820s draws the world-image of Rome as a historical reality. The parallels Moscow ''the Third Rome'', St. Petersburg Rome tell about the immersion in Roman history. Rome becomes a representative of the Russian public consciousness of the era of ''civil exaltation". So from Batyushkov to Gogol the Russian language culture forms the concept of ''reading Rome''. The poetry of the 1820s elaborates on this idea as on the idea of spiritual and mental enlightenment of Rome. Images of the Roman antiquity, the names of Roman historians, the orator Cicero, the poet Ovid determine the allusion subtexts of the Decembrist poetry (K. Ryleev, F. Glinka, W. Kuchelbecker, P. Katenin), create the peculiar atmosphere of a Roman political masquerade. Pushkin's poem ''To Licinius'', the message of A.A. Shishkov ''To Metellus'', the role masks of famous figures of Roman history and culture in ''Arzamas'', the shadows of Tasso and Ovid offer new features of the world-image of Rome. This material determines the content of the second part of the paper. The poetry of the 1830s in the atmosphere of the ''era of stagnation'' actualizes the image of Rome as a symbol of the loss of ideals and hopes. At the same time the poets of the salon of Zinaida Volkonskaya and visitors of her Roman villa outline the route of the Russian poetry to the world image of the visible Rome, Rome as a ''reality with a heart''. Poetry of E. Baratynsky and S. Shevyrev is the prologue to the understanding of Rome as a society and a philosophical model of existence. The route to the prose introduces the Roman carnival element as the element of people's lives to the genetic code of the Russian poetic culture. The 1840s is a new stage in the poetic reading of Rome. This was the route to the real picture of the world-image. From the burlesque poem by Ivan Myatlev ''Sensations and comments of Mrs. Kurdyukova abroad.'' to the poetic cycle of Apollon Maikov ''Sketches of Rome'' the Russian poetry made its way to the domestication of Rome, to its depicting in faces and scenes. The Eternal City is a symbol of eternal life. The poem ''Rome'' by P. Vyazemsky was a kind of resume of the journey of the Russian poetry in the reading and the image of Rome-world. Russian Poetry of the 1810-1840s successively opened Rome and its world-image as a polysemantic local text, and at the same time in the process it revealed the idea of ''universal responsiveness'' of the Russian literature.
El presente proyecto formulado para el Carnaval de Negros y Blancos de San Juan de Pasto, inicia principalmente considerando el carnaval como PATRIMONIO vivo y con una evolución constante, patrimonio que pertenece a todos los portadores de su identidad y que así mismo se debe proteger. De este modo, se propone para su adecuado desarrollo, un plan de "marketing" enmarcado dentro de una estructura organizacional de empresa cultural, contextualizada a las tendencias del entorno donde se lleva a cabo la manifestación cultural mas importante de la región; igualmente, considerando las principales necesidades, riesgos y amenazas que presenta el carnaval, se busca mostrar el valor de la manifestación como una enorme oportunidad que brinda escenarios de desarrollo económico, social, político y cultural para todos sus stakeholders. En primer lugar se identifica el comportamiento del entorno y el estado actual del carnaval, para tal efecto, se realiza revisión bibliográfica, desk research y entrevistas en profundidad con expertos conocedores y organizadores de la manifestación, igualmente, se participó en la elaboración del Plan Especial de Salvaguardia 2010 como directriz y política cultural establecida por el Ministerio de Cultura de Colombia. Posteriormente con la información recolectada se realiza un diagnostico, el cual permite determinar el mercado, es decir, los actores que intervienen o satekeholders del carnaval, cuales son sus necesidades o beneficios que reciben de la manifestación cultural y como el carnaval puede satisfacer sus expectativas. Una vez identificado el mercado se segmenta, en otras palabras, se agrupan los actores que comparten características o comportamientos, para así, proponer estrategias y acciones precisas a cada grupo, basadas en los principios de pensamiento y acción de la gestión de "marketing" en un portafolio de productos y servicios eficiente. A medida que se desarrolla el trabajo, el carnaval se enfoca en sentido empresarial, integrando a la organización todos sus stakeholders, con el fin de alinearlos para desarrollar un trabajo conjunto que mejore la calidad de vida de la comunidad local y promueva el desarrollo político, económico, social y cultural de la región / Abstract: This project formulated for the Carnival of Blacks and Whites in Pasto, especially considering the carnival began as a living heritage and continually evolving heritage belonging to all carriers of their identity and so it should be protected. Thus, it is proposed for their proper development, a plan of "marketing" framed within a cultural enterprise organizational structure, consonant with environmental trends which holds the most important cultural event in the region, also considering the main needs, risks and threats presented by the Carnival, aims to show the value of the event as a huge opportunity that provides scenarios of economic, social, political and cultural benefit to all stakeholders. First, it identifies the behavior of the environment and the current state of carnival, for this purpose, literature review is conducted, desk research and interviews with knowledgeable experts and organizers of the event, also participated in drafting the Special Plan 2010 Safeguarding cultural policy as a guideline established by the Ministry of Culture of Colombia. Later, with the information collected is made a diagnosis, which determines the market, ie the actors involved or satekeholders carnival, what are their needs or benefits they receive from the cultural event and as the carnival can meet their expectations. Having identified the market segments, in other words, are grouped actors who share characteristics or behaviors, thus, propose specific strategies and actions to each group, based on the principles of thought and action of the management of "marketing" in a portfolio of products and services efficiently. As the work develops, the carnival is focused in a business sense, integrating the organization all its stakeholders, to align them to develop a joint effort to improve the quality of life of the local community and promote the political, economic, social and cultural development of the region. ; Maestría
In: Coleman , T , Agboola , S , Leonardi-Bee , J , Taylor , M , McEwen , A & McNeill , A 2010 , ' Relapse prevention in UK Stop Smoking Services : current practice, systematic reviews of effectiveness and cost-effectiveness analysis ' Health technology assessment (Winchester, England) , vol 14 , no. 49 , pp. 1-152, iii-iv . DOI:10.3310/hta14490
Background Reducing smoking is a chief priority for governments and health systems like the UK National Health Service (NHS). The UK has implemented a comprehensive tobacco control strategy involving a combination of population tobacco control interventions combined with treatment for dependent smokers through a national network of NHS Stop Smoking Services (NHS SSS). Objectives To assess the effectiveness and cost-effectiveness of relapse prevention in NHS SSS. To (1) update current estimates of effectiveness on interventions for preventing relapse to smoking; (2) examine studies that provide findings that are generalisable to NHS SSS, and which test interventions that might be acceptable to introduce within the NHS; and (3) determine the cost-effectiveness of those relapse preventions interventions (RPIs) that could potentially be delivered by the NHS SSS. Data sources A systematic review of the literature and economic evaluation were carried out. In addition to searching the Cochrane Tobacco Addiction Group register of trials (2004 to July 2008), MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, the Science Citation Index and Social Science Citation Index were also searched. Review methods The project was divided into four distinct phases with different methodologies: qualitative research with a convenience sample of NHS SSS managers; a systematic review investigation the efficacy of RPIs; a cost-effectiveness analysis; and a further systematic review to derive the relapse curves for smokers receiving evidence-based treatment of the type delivered by the NHS SSS. Results Qualitative research with 16 NHS SSS managers indicated that there was no shared understanding of what relapse prevention meant or of the kinds of interventions that should be used for this. The systematic review included 36 studies that randomised and delivered interventions to abstainers. 'Self-help' behavioural interventions delivered to abstainers who had achieved abstinence unaided were effective for preventing relapse to smoking at long-term follow-up [odds ratio (OR) 1.52, 95% confidence interval (CI) 1.15 to 2.01]. The following pharmacotherapies were also effective as RPIs after their successful use as cessation treatments: bupropion at long-term follow-up (pooled OR 1.49, 95% CI 1.10 to 2.01); nicotine replacement therapy (NRT) at medium- (pooled OR 1.56, 95% CI 1.16 to 2.11) and long-term follow-ups (pooled OR 1.33, 95% CI 1.08 to 1.63) and one trial of varenicline also indicated effectiveness. The health economic analysis found that RPIs are highly cost-effective. Compared with 'no intervention'; using bupropion resulted in an incremental quality-adjusted life-year (QALY) increase of 0.07, with a concurrent NHS cost saving of 68 pounds; for NRT, spending 12 pounds resulted in a 0.04 incremental QALY increase; varenicline resulted in a similar QALY increase as NRT, but at almost seven times the cost. Extensive sensitivity analyses demonstrated that cost-effectiveness ratios were more sensitive to variations in effectiveness than cost and that for bupropion and NRT, cost-effectiveness generally remained. Varenicline also demonstrated cost-effectiveness at a 'willingness-to-pay' threshold of 20,000 pounds per QALY, but exceeded this when inputted values for potential effectiveness were at the lower end of the range explored. For all drugs, there was substantial relapse to smoking after treatment courses had finished. Quit attempts involving NRT appeared to have the highest early relapse rates, when trial participants would be expected to still be on treatment, but for those involving bupropion and varenicline little relapse was apparent during this time. Limitations The qualitative research sample was small. Conclusions Based on the totality of evidence, RPIs are expected to be effective and cost-effective if incorporated into routine treatment within the NHS SSS. While staff within the NHS SSS were largely favourably inclined towards providing RPIs, guidance would be needed to encourage the adoption of the most effective RPIs, as would incentives that focused on the importance of sustaining quit attempts beyond the currently monitored 4-week targets.
La autonomía universitaria. Discurso ideológico instituido o razón doctrinaria del ser de la universidad.The university autonmy. Instituted ideological speech or doctrinaire reason of the university essence. Rivas, Pedro José Narrar, educar y filosofar: las novelas del programa de filosofía para niños.Narrate, educate and philosophize: the novels of the philosophy program for children. Carmona, María ¿Evaluando o midiendo?Evaluating or measuring? Rivas M., Rebeca E. El paradigma del pensamiento complejo en la didáctica de la química: una visión desde el átomo a la materia.The paradigm of complex thinking in chemistry pedagogy: a vision from the matter's atom. Escalona, José y Fontal, Bernardo El contexto histórico, el cambio paradigmático y sus repercusiones en la enseñanza y el aprendizaje en la práctica escolar cotidiana.The historical context, the paradigmatic change and its repercussions in teaching and learning in everyday school practice. Santiago Rivera, José Armando El aula de la educación superior: un enfoque comparado desde la visión y misión de la universidad tradicional y la multidiversidad compleja.University education classroom, a compared approach from the traditional university's vision and mission and the complex multi-diversity. Méndez Andrade, Raizabel; Martínez, Don Rodrigo; De Jesús Gonzáles, María Inés y Andrade, Raiza Tendencias organizacionales del profesor universitario de ingeniería.Organizational tendencies of engineering university professors. Meléndez, Luis E. Eje transversal. "Valores" en la educación básica: teoría y praxis.Transversal axis values in primary education: theory and praxis. Fernández, Osmaria; Lúquez, Petra; Ocando Medina, Jenny y Liendo, Zoleida Las TIC y la metodología de proyectos de aprendizaje. Algunas experiencias en formación docente.The CITS and the methodology of learning projects: some experiences in teachers' education. Torrealba, Gualberto Infuencia de los padres en la educación sexual de los adolescentes.Influence of parents on teenagers' sexual education. Caricote Agreda, Esther A. Representación del pensamiento en adolescentes excluidos: poder para vencer la vulnerabilidad social.Representation of thought in excluded teenagers: power to overcome social vulnerability. Márquez, Emilia y Anzola, Myriam Una experiencia para estimular la composición escrita en estudiantes universitarios de formación docente.An experience to stimulate written composition on teacher's education university students. Barboza P., Francis D.; Aguirre de Ramírez, Rubiela y Peña González, Josefina La educación cooperativa en la escuela: el caso Québec.Cooperative education in schools: the Quebec case. St-Pierre, Isabell y Richer, Madeleine Nuevos retos y perspectivas, peligros y acechanzas de la autonomía universitaria en tiempos de reforma constitucional en Venezuela.New challenges and perspectives, dangers and threats of university autonomy in times of constitutional reform in Venezuela. Autonomía universitaria y reforma constitucional.University autonomy and constitutional reform. Fuenmayor Toro, Luis La imposibilidad actual de la autonomía universitaria.The current impossibility of university autonomy. Fuenmayor Arocha, Ramsés Leonardo Universidad, libertad académica y autonomía universitaria.University, academic freedom and autonomy. Belmonte, Amalio Siete realidades capitales de la autonomía universitaria.Seven capital realities of university autonomy. Monagas, Antonio José La educación matemática en la franja crítica de la escolaridad y el currículo de la educación básica.Mathematical education on the critical strip of schooling and the primary education curriculum. Rivas, Pedro José Simón Rodríguez: el proyecto de una educación social.The project of a "social education". Paladines, Carlos Don Simón Rodríguez. Jáuregui, Ramón M. Paulo Freire: gusto por la libertad y pasión por la justicia.Paulo Freire: liking for freedom and passion for justice. Ovelar Pereyra, Nora La enseñanza de la lengua y la literatura en la voz de Carlos Lomas.Dialogs with. Carlos Lomas. Teaching of language and literature. Bruzual Leal, Raquel La evaluación en el sistema educativo bolivariano.Evaluation in the bolivarian educational system. Ministerio del Poder Popular para la Educación Pensar la educación: anuario del doctorado en educación 2006. Reseñado por: Alonso, Leonor Voz y escritura. Revista de estudios literarios. Reseñado por: Puerta de Pérez, Maén ; 177-187 ; novelar@cantv.net ; trimestral ; Nivel analítico
Este proyecto es una continuación del realizado entre 2005-2007 a la vez que supone una nueva impostación: el tema sigue siendo la argumentación como discurso pedagógico pero el propósito actual es su promoción en el contexto específico del aula de educación superior a través de programas de cátedras cuyos núcleos temáticos de cultura griega se estructuran en torno a dicho eje. Se trata de una investigación interdisciplinaria en la que interactúan la lengua griega, la filosofía de la cultura, la lógica (en su modalidad aplicada), la retórica y la historia. Es, por otra parte, una investigación aplicada, cuya hipótesis postula: Una mediación pedagógica continuada (centrada en el debate de situaciones vitales controvertidas de la Antigüedad Griega y que respete ciertas condiciones) promueve la capacidad argumentativa y las competencias implicadas en ella, en jóvenes de los primeros años de la educación superior en especialidades humanísticas. Supone, entonces, adentrarse en el reino de "lo práctico", "(.) aquel de los problemas ill-structured que emergen de la vida en tanto vivida. Es el dominio que ha sido descripto por Wittgenstein como 'el tosco o áspero suelo' y más recientemente por Donald Schon como 'el suelo pantanoso'. La muerte de un niño. La pregunta de un alumno. El conflicto político. La resistencia de un adolescente. Cómo debemos responder en cada una de estas ocasiones es más que una pregunta epistemológica. Entrar en lo práctico significa entrar en el reino de la incertidumbre, la ambigüedad y el desacuerdo legítimo. Enraizado en lo particular y lo concreto, lo práctico anuncia una sabiduría y una ética de lo propio, que Aristóteles llamó frónesis." (Phelan, 2001: 41) En consecuencia, operará como lugar de síntesis de elementos materiales y formales y se centrará en la promoción de una lingüística del texto a la que se sumarán estrategias didácticas específicas y transversales que convengan a cada caso. Por ello, se implementarán experiencias pedagógicas con instancias de evaluación diagnóstica, formativa y sumativa a propósito de textos y situaciones argumentativos vinculados con la historia, el mito y la filosofía, el arte y la literatura, en un enfoque diacrónico. ; This is an extension of the 2005-2007 project but at the same time it implies a new angle: the subject is still argumentation as pedagogical discourse but the actual aim is its promotion in the specific context of undergraduate classrooms through syllabuses based on Hellenic culture themes. It is an interdisciplinary research project in which Greek culture, culture philosophy, applied logic, rhetoric and history come into play with one another. It is a practical exploration whose premise purports the following: a continuous educational mediation (centered in the discussion of controversial vital situations of ancient Greek culture and that meets certain conditions) promotes young students' argumentative capacity and the competences involved as they attend the first years of Humanities programs. Therefore, it involves going into the realm of "the practical", (…) "that of the ill-structured troubles which spring from life as it is experienced. It is the realm which has been described by Wittgenstein as "the rough and harsh ground" and lately as "the swampy ground" by Donald Schon. A child's death. A student' s question. Conflict in politics. A teenager's wilfulness. How to answer to each of these issues is more than an epistemological query. Going into the practical means to go into the realm of the uncertainty, ambiguity and genuine disagreement. Grounded in a particular and concrete basis, the practical announces a wisdom and an ethics Aristotle called phronesis (Phelan, 2001: 41). In consequence, the project seeks to operate as a place of synthesis of material and formal elements and it will focus on the promotion of text linguistics which specific and transversal teaching strategies -which would be appropriate to each case- will add up. That is why pedagogical practices will be set up, with placement, instructional and cumulative instances of testing on argumentative texts and situations related to history, myth, philosophy, art and literature, in a diachronic approach.
Background: The prevalence of type 2 diabetes mellitus (T2D) and the number of patients with comorbidities like hypertension, dyslipidemia and cardiovascular diseases are increasing worldwide. Evidence-based medicine uses the best available evidence from systematic research to make decisions about the care of individual patients. The systematisation and appraisal of evidence are done in care guidelines, which in turn aim to guide the application of effective diabetes prevention and care interventions in different age groups and settings. Patients with T2D need continuous and individualised care. They are therefore seen as the ideal target group for the use of digital health interventions like telemedicine. However, heterogeneous patient populations, telemedicine phenotypes and settings hamper the evaluation of digital health interventions. Comparing study results to provide evidence-based recommendations is further complicated by the diversity of applied study designs. Therefore, there is a need for a systematic review of the current state of research while considering the described variability. In line with this aim five research studies were conducted. Objective: The overall objective of this thesis was, to identify current needs of patients with diabetes (publication 1), to systematically analyse the effectiveness of different diabetes prevention and care interventions (publications 2+3) and to evaluate digital diabetes prevention and care interventions (publications 4+5). Material und Method: To analyse current needs of patients with diabetes, three substudies were conducted in the beginning (publication 1). They consisted of a standardised survey of experts to analyse existing chronic care programs, an expert workshop to identify patients' needs and an online survey to prioritise the categorised needs dimensions seen from the perspective of patients and health care providers. Two literature overviews were performed to analyse the best available evidence in diabetes prevention and care. An umbrella review analysed the available evidence to identify effective interventions of blood sugar regulation on cardiovascular risk (publication 2). Study quality was assessed using OQAQ (Overview Quality Assessment Questionnaire). Afterwards, a literature overview aimed to identify effective measures of population-based prevention and communication strategies to provide recommendations for policy makers on how to prevent diabetes in different age groups and settings (publication 3). In a next step, digital diabetes prevention and care interventions were summarised. To evaluate digital health interventions with more than one active function, a study protocol was developed. It describes the evaluation of a hypothetical gamification-based smartphone application for weight loss in overweight and obese adolescents (publication 4). As a last step, an umbrella review (publication 5) systematically analysed the effectiveness of telemedicine interventions in diabetes, dyslipidaemia and hypertension. Potentially relevant records had to analyse the effectiveness of telemedicine on clinical outcomes under real-life conditions in patients with one of the defined target diseases using either a systematic review or meta-analysis based on RCTs. Results of meta-analyses and their subgroup analyses were used to identify effective components or other characteristics (e.g. intensity or frequency of feedback). Overall certainty of outcomes was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. Results and Implications: The standardised survey on current care models indicated that a lack of national guidelines, cost-ineffective and non-individualised health care as well as long waiting periods were criticised. Education of patients, communication within the team and with the patient, prevention and health promotion as well as the accessibility of services were significantly more important to patients when compared to health care providers. The identified differences in priorities support the early assessment of these preferences. The umbrella review on the potential of blood sugar regulation for the reduction of cardiovascular risk identified 44 records which were of good quality (OQAQ-median = 17). The results suggest that pharmacological and non-pharmacological interventions have the potential to improve cardiovascular outcomes. When deciding for a certain intervention as well as its intensity, baseline blood pressure and cardiovascular risks of the patient should be considered. Guidelines on cardiovascular prevention should take into account pathophysiological mechanisms as well as individual lifestyle interventions. While effective measures for individual level prevention including physical activity and diet programs were found, available evidence for population-based intervention was scarce and insufficient. The literature overview conducted afterwards identified evidence-based interventions for population-based prevention, including taxation of unhealthy products and specific prevention strategies in certain settings (e.g. kindergartens, schools). These strategies may contribute to the development of policies and governmental regulations for the prevention of diabetes in different age groups and settings. To evaluate a digital mobile health intervention consisting of more than one component, a study protocol for a single-centre, two-arm, triple-blinded, randomised controlled trial following the CONSORT recommendations was developed. The intervention consists of a smartphone application that provides both tracking and gamification elements for lifestyle change. The control group uses an identically designed application, which solely features the tracking of health information. It appears favourable to use RCTs for proof of concept assessments, to evaluate the effectiveness of an app or specific components in controlled settings. The fifth publication of this thesis shows that telemedicine may lead to significant and clinically relevant reductions of HbA1c (≤ -0,5 %) in patients with T2D. The identified reduction rates are comparable to those of non-pharmacological and even some pharmacological interventions. Extracted subgroup analyses showed that certain population and intervention characteristics seem to be associated with improved clinical benefits. This applies to interventions with a rather short duration ( 8,0 %) were identified as population characteristics favourable for clinically relevant improvements of HbA1c. In addition to the characteristics, future updates of guidelines should carefully consider the low levels of certainty as indicated by the low GRADE results. The present thesis provides a systematic overview of effective measures in diabetes prevention and care. Overall, there is a potential for the early and structured assessment of patients' preferences. The systematisation and appraisal of the best available evidence on the effectiveness of telemedicine in patients with diabetes and associated comorbidities revealed areas for the update of present guidelines. There is a need for methodologically robust studies on the effectiveness of telemedicine in specific populations and in consideration of combined digital health components. The results and identified research needs have the potential to motivate future studies.:Inhaltsverzeichnis I Abkürzungsverzeichnis III Abbildungsverzeichnis VI Tabellenverzeichnis VII Liste der entstandenen Publikationen VIII 1 Einführung in die Thematik 1 1.1 Diabetes 1 1.1.1 Epidemiologie 1 1.1.2 Krankheitstypen, Krankheitsstadien und Begleiterkrankungen 2 1.1.3 Diabetesprävention 5 1.1.4 Diabetesversorgung 6 1.2 Evidenzbasierte Medizin 9 1.3 Digitalisierung 14 1.4 Stand der Forschung 15 1.4.1 Unterstützungs- und Versorgungsprobleme 15 1.4.2 Individuelle und populationsbasierte Maßnahmen zur Diabetesprävention 16 1.4.3 Herausforderungen digitaler Diabetesprävention und -versorgung 22 1.5 Zieldefinition und Fragestellung 25 2 Thematischer Zusammenhang und Methodenüberblick 26 3 Individualising Chronic Care Management by Analysing Patients' Needs – A Mixed Method Approach 28 4 Blood Sugar Regulation for Cardiovascular Health Promotion and Disease Prevention 31 5 What should governments be doing to prevent diabetes throughout the life course? 34 6 Efficacy of gamification-based smartphone application for weight loss in overweight and obese adolescents: study protocol for a phase II randomized controlled trial 36 7 Mapping the Evidence on the Effectiveness of Telemedicine Interventions in Diabetes, Dyslipidemia, and Hypertension: An Umbrella Review of Systematic Reviews and Meta-Analyses 38 8 Diskussion und Ausblick 41 8.1 Einordnung der Ergebnisse 41 8.2 Limitationen und Methodenkritik 49 8.3 Wissenschaftliche Kontribution und Ausblick 50 9 Schlussfolgerung 51 10 Zusammenfassung 53 11 Summary 57 12 Literaturverzeichnis 60 13 Anhang 110 13.1 Wissenschaftliche Kontribution der Publikationen 110 13.2 Details zu Publikationen als Erstautor 112 13.3 Volltexte der entstandenen Veröffentlichungen 117 13.4 Curriculum Vitae 198 13.5 Danksagung 199 Anlage 1 200 Anlage 2 202 ; Hintergrund: Die Häufigkeit des Typ-2-Diabetes mellitus (T2D) sowie die Zahl von Patienten mit Begleiterkrankungen wie Hypertonie, Lipidstoffwechselstörungen und kardiovaskulären Erkrankungen sind weltweit ansteigend. Die evidenzbasierte Medizin nutzt die beste verfügbare Evidenz aus systematischer Forschung um Entscheidungen für die individuelle Patientenversorgung zu treffen. Die Aufarbeitung und Bewertung der Evidenz erfolgt in Versorgungsleitlinien, welche wiederum zur Verwendung wirksamer Maßnahmen der Diabetesprävention und -versorgung in verschiedenen Altersgruppen und Settings anleiten können. Patienten mit T2D bedürfen der kontinuierlichen und individualisierten Versorgung. Sie gelten daher als ideale Patientengruppe, um digitale Versorgungsformen wie Telemedizin zu nutzen. Heterogene Patientenpopulationen, Telemedizinanwendungen und Settings erschweren jedoch die Evaluation digitaler Gesundheitsanwendungen. Zusätzlich wird durch die Diversität der angewandten Studiendesigns ein Vergleich der Studienergebnisse, mit dem Ziel evidenzbasierte Empfehlungen zu formulieren, verkompliziert. Es fehlt daher an einer systematischen Aufarbeitung des Forschungsstands unter Berücksichtigung der geschilderten Variabilität. Mit diesem Ziel wurden fünf Forschungsarbeiten angefertigt. Fragestellung: Übergeordnetes Ziel der vorliegenden Arbeit war es, bestehende Unterstützungs- und Versorgungsprobleme von Patienten mit Diabetes zu identifizieren (Publikation 1), die Wirksamkeit verschiedener Maßnahmen der Prävention und Versorgung des Diabetes systematisch aufzubereiten (Publikationen 2+3) und digitale Diabetespräventions- und –versorgungsstrategien zu bewerten (Publikationen 4+5). Material und Methode: Mit dem Ziel, bestehende Unterstützungs- und Versorgungsprobleme von Patienten mit Diabetes zu analysieren, wurden zu Beginn drei Teilstudien durchgeführt (Publikation 1). Diese beinhalteten eine standardisierte Expertenbefragung zu bestehenden Versorgungsmodellen, einen Workshop zur Identifikation von Versorgungs- und Unterstützungsproblemen und die Durchführung einer mehrsprachigen Online-Befragung zur Priorisierung der kategorisierten Problembereiche aus Sicht der Patienten und Leistungserbringer. Zur Analyse der besten verfügbaren Evidenz zur Diabetesprävention und –versorgung wurden zwei Übersichtsarbeiten durchgeführt. Ein Umbrella Review untersuchte die verfügbare Evidenz effektiver Maßnahmen der Blutzuckerregulation auf das kardiovaskuläre Risiko (Publikation 2). Die Studienqualität wurde durch OQAQ (Overview Quality Assessment Questionnaire) bewertet. Im Anschluss hatte eine Literaturübersicht das Ziel, wirksame Maßnahmen der Verhältnisprävention sowie Kommunikations-strategien zu identifizieren, um Handlungsempfehlungen abzuleiten, wie politische Entscheidungsträger in verschiedenen Altersgruppen und Settings Diabetes verhindern können (Publikation 3). In einem nächsten Schritt wurden Ansätze der digitalen Diabetesprävention und –versorgung aufgearbeitet. Zur Evaluation von digitalen Interventionen mit mehr als einer aktiven Funktion wurde ein Studienprotokoll entwickelt. Dieses beschreibt die Evaluation einer (hypothetischen) spielbasierten mobilen Applikation zur Gewichtsreduzierung bei übergewichtigen und adipösen Jugendlichen (Publikation 4). Im letzten Schritt wurde ein Umbrella Review (Publikation 5) durchgeführt, um die Wirksamkeit von Telemedizin bei Patienten mit Diabetes, Lipidstoffwechselstörungen und Hypertonie systematisch zu erheben. Potentiell relevante Forschungsarbeiten mussten die Wirksamkeit (effectiveness) von Telemedizin auf klinische Outcomeparameter unter realweltlichen Bedingungen bei mindestens einer der definierten Erkrankungen in Form von systematischen Übersichtsarbeiten und Meta-Analysen auf Basis von RCTs untersucht haben. Ergebnisse von Meta-Analysen und deren Subgruppenanalysen wurden herangezogen, um effektive Funktionen oder andere Charakteristika (z.B. Intensität oder Häufigkeit von Feedback) zu identifizieren. Um das Vertrauen in den Effektschätzer der Subgruppenanalysen zu bewerten, wurde das GRADE-Schema (Grading of Recommendations Assessment, Development and Evaluation) angewandt. Ergebnisse und Schlussfolgerungen: Die standardisierte Befragung zu verfügbaren Versorgungsmodellen von Patienten mit Diabetes ergab, dass das Fehlen nationaler Versorgungsleitlinien, nicht kosteneffektive und nicht-individualisierte Versorgung sowie lange Wartezeiten häufig bemängelt wurden. Für die befragten Patienten waren im Vergleich zu den befragten Leistungserbringern die Patientenschulung, Kommunikation im Behandlungsteam und mit dem Patienten, die Prävention und Gesundheitsförderung, sowie die Verfügbarkeit der Versorgungsdienstleistungen signifikant wichtiger. Die identifizierten unterschiedlichen Prioritäten zwischen den an der Versorgung beteiligten Akteuren legen nahe, diese Präferenzen frühzeitig zu erfassen. Der Umbrella Review zum Potential der Blutzuckerregulation für Verbesserungen kardiovaskulärer Risiken identifizierte 44 Übersichtsarbeiten mit mehrheitlich guter Qualität (OQAQ-Median = 17). Unter Berücksichtigung unterschiedlicher Endpunkte legen die Erkenntnisse nahe, dass sowohl pharmakologische als auch nicht-pharmakologische Interventionen kardiovaskuläre Endpunkte verbessern können. Die Entscheidung für eine Intervention und ihre Intensität sollte neben dem Blutdruck auch das bestehende kardiovaskuläre Risiko zu Beginn der Behandlung berücksichtigen. Leitlinien im Bereich der kardiovaskulären Prävention sollten sowohl pathophysiologische Mechanismen als auch individuelle verhaltensorientierte Präventionsmaßnahmen einbeziehen. Während im Bereich der Verhaltensprävention wirksame Strategien, wie die Steigerung der körperlichen Aktivität und die Anpassung der Ernährungsgewohnheiten, identifiziert wurden, war die verfügbare Evidenz von populationsbasierten Maßnahmen der Verhältnisprävention im durchgeführten Umbrella Review begrenzt und nicht belastbar. Die im Anschluss durchgeführte Literaturübersicht konnte jedoch belastbare Evidenz zur Verhältnisprävention, wie die Besteuerung ungesunder Nahrungsmittel und spezifische Präventionsmaßnahmen in Settings (z.B. Kindergarten, Schule etc.), identifizieren. Diese Ansätze können dazu beitragen, regulatorische Maßnahmen zur Diabetesprävention in verschiedenen Altersgruppen und Settings zu entwickeln. Zur Evaluation einer mobilen digitalen Gesundheitsanwendung mit mehreren Funktionen wurde ein CONSORT-konformes Studienprotokoll für eine monozentrische, zweiarmige, dreifach verblindete, randomisierte, kontrollierte Studie entwickelt. Die Intervention bestand aus einer Smartphone-Applikation, die "Tracking" und spielerische Anregungen zur Lebensstiländerung verbindet. Die Kontrollgruppe erhielt eine Smartphone-Applikation mit identischem Design, die jedoch ausschließlich Tracking von Gesundheitsinformationen anbietet. Im Rahmen des frühen Wirksamkeitsnachweises scheinen RCTs hilfreich, um die Wirksamkeit einer App bzw. ausgewählter Funktionen klinisch kontrolliert zu testen. Die fünfte Publikation der vorliegenden Dissertation zeigt, dass Telemedizin den HbA1c bei Patienten mit T2D klinisch relevant (≤ -0,5 %) reduzieren kann. Die identifizierten Reduktionsraten sind mit jenen von etablierten lebensstilmodifizierenden und selbst einigen pharmakologischen Interventionen vergleichbar. Extrahierte Subgruppenanalysen legen nahe, dass bestimmte Populations- und Interventionscharakteristika mit einer gesteigerten Wirksamkeit assoziiert sind. Hierzu gehören Interventionen mit relativ kurzer Dauer ( 8,0 %) wurden als Patientencharakteristika identifiziert, bei denen Telemedizin zu klinisch relevanten und signifikanten Verbesserungen des HbA1c führte. Neben diesen Charakteristika sollten zukünftige Leitlinienupdates das geringe Vertrauen in die Effektschätzer, in Form der schlechten GRADE Bewertungen, berücksichtigen. Die vorliegende kumulative Dissertation liefert einen Beitrag zur systematischen Übersicht über wirksame Ansätze der Diabetesprävention und –versorgung. In der Gesamtschau zeigt sich ein Potential für die frühzeitige und strukturierte Berücksichtigung von Patientenpräferenzen. Durch die Aufbereitung und methodische Bewertung der verfügbaren Evidenz zur Wirksamkeit von Telemedizin bei Diabetes und assoziierten Begleiterkrankungen wurden Ansätze für die gezielte Aktualisierung bestehender Leitlinien identifiziert. Es besteht ein Bedarf für methodisch robuste Studien zur Wirksamkeit von Telemedizin in spezifischen Populationen und unter Berücksichtigung der Kombination digitaler Interventionsfunktionen. Die Ergebnisse und identifizierten Forschungsbedarfe haben das Potential, zukünftige Studien zu motivieren.:Inhaltsverzeichnis I Abkürzungsverzeichnis III Abbildungsverzeichnis VI Tabellenverzeichnis VII Liste der entstandenen Publikationen VIII 1 Einführung in die Thematik 1 1.1 Diabetes 1 1.1.1 Epidemiologie 1 1.1.2 Krankheitstypen, Krankheitsstadien und Begleiterkrankungen 2 1.1.3 Diabetesprävention 5 1.1.4 Diabetesversorgung 6 1.2 Evidenzbasierte Medizin 9 1.3 Digitalisierung 14 1.4 Stand der Forschung 15 1.4.1 Unterstützungs- und Versorgungsprobleme 15 1.4.2 Individuelle und populationsbasierte Maßnahmen zur Diabetesprävention 16 1.4.3 Herausforderungen digitaler Diabetesprävention und -versorgung 22 1.5 Zieldefinition und Fragestellung 25 2 Thematischer Zusammenhang und Methodenüberblick 26 3 Individualising Chronic Care Management by Analysing Patients' Needs – A Mixed Method Approach 28 4 Blood Sugar Regulation for Cardiovascular Health Promotion and Disease Prevention 31 5 What should governments be doing to prevent diabetes throughout the life course? 34 6 Efficacy of gamification-based smartphone application for weight loss in overweight and obese adolescents: study protocol for a phase II randomized controlled trial 36 7 Mapping the Evidence on the Effectiveness of Telemedicine Interventions in Diabetes, Dyslipidemia, and Hypertension: An Umbrella Review of Systematic Reviews and Meta-Analyses 38 8 Diskussion und Ausblick 41 8.1 Einordnung der Ergebnisse 41 8.2 Limitationen und Methodenkritik 49 8.3 Wissenschaftliche Kontribution und Ausblick 50 9 Schlussfolgerung 51 10 Zusammenfassung 53 11 Summary 57 12 Literaturverzeichnis 60 13 Anhang 110 13.1 Wissenschaftliche Kontribution der Publikationen 110 13.2 Details zu Publikationen als Erstautor 112 13.3 Volltexte der entstandenen Veröffentlichungen 117 13.4 Curriculum Vitae 198 13.5 Danksagung 199 Anlage 1 200 Anlage 2 202
Tese de doutoramento em Direitos Humanos nas Sociedades Contemporâneas, apresentada ao Instituto de Investigação Interdisciplinar da Universidade de Coimbra ; The current democratization of Mozambique has to be described and analyzed in relation to a vast array of existing mechanisms of citizen consultation and participation at local level. This has entailed electoral citizen-centric processes, negotiations, and discourses on development plans, concomitant with budget allocations devised to ensure consensual decision-making. There is strong evidence in the literature to show that participatory governance mechanisms directly contribute to deepening local democracy in cities and municipalities that have adopted it around the world. Consequently, its adoption and implementation became increasingly in many countries and is being taken to sustain administrative and political reforms throughout developing countries. However, whereas there is extensive literature on the topic of local democracy, participatory budgeting concerning the rights to municipal and urban development remains one of the most under-explored aspects of democratic decentralization (Cabannes & Delgado 2015; Chigbu et al. 2017). Yet, it is crucial that if we are to understand how decentralization contributes to the promotion of urban development, two aspects of human rights pertinent to urban development are essential, they are the right to the city and inclusionary rights to urban planning. The main purpose of this doctoral dissertation is to examine the socioeconomic and political role played by citizens and a set of local actors (civil society organizations; local consultative councils; public participation professionals; NGOs; local government; and private sector) through participatory processes that promote urban development and social well-being in Mozambique. It demonstrates how the mechanism of decentralization has contributed to enhancing the protection of right to the city and the promotion of local democracy. The dissertation questions a variety of concepts and methods, from the social and economic perspective to the political relationships among the actors involved. Furthermore, it presents how the citizens' rights to participate in public affairs is granted and promoted through bottom-up democratic innovations, and its interactions with the top-down mechanisms. Its methodological approach is based on transnational models of citizen participation in urban affairs proposed by Sintomer et al., (2012; 2013) and Arnstein (1969)' ladder of citizen participation, to study the degrees of citizen involvement in municipal planning and participatory budgeting. The dissertation explored two case studies: the urban planning in Maxixe in the south and, the Quelimane participatory budgeting in central Mozambique. Due to the aims of this dissertation and its adopted methodology, the practical research is based on data collection from secondary sources; and participatory action research that explored the role played by all stakeholders who operate significant social changes in both Maxixe and Quelimane. The researcher spent eight months observing local dynamics, attending public consultation meetings and addressing questions and issues relevant to the study. To analyse the complex framework of this study, the researcher applied grounded theory and document analysis because it allows departure from the case study to the conception of a theory during data analysis. Based on the analyses made, this dissertation argues that, despite the great emancipatory capacity tied to participatory budgeting process in Mozambique and the actions taken to promote citizens' engagement in urban development, the rights to participate in the conception, management and enjoyment of the city is stratified upon territorial asymmetry and thus is not equally granted to all Mozambican citizens. Consequently, there are social resentment and a potential conflict of interests which may turn into a total distrust of the democratic institutions and its incumbents resulting from the degree of non-participation. Even though the idea of participatory budgeting in Mozambique is usually associated with a mechanism of social and economic development, in practice, the local participatory budgeting process is not necessarily linked to the promotion of urban development or to the citizens' rights to the city. It is oriented to operate inter-institutional innovations and modernization of the public administration procedures in line with the process of decentralization, deconcentration and local power sharing. Therefore, the citizen involvement in the urban affairs is restricted to a symbolic act of consultation (direct or by representation) to legitimating the urban planning and activities. Given this situation, citizens are powerless to influence and change the decisions already taken. In fact, Mozambique is yet to promote and secure full citizenship rights to the city and urban development. ; O atual processo de democratização em Moçambique deve ser visto na sua relação com os inúmeros mecanismos de consulta e participação pública nas deliberações locais, visíveis num processo eleitoral baseado no indivíduo, nas negociações e discussões dos planos de desenvolvimento e os respetivos orçamentos. Há evidências na literatura que comprovam que os mecanismos de governação participativa contribuem diretamente para o aperfeiçoamento da democracia local nas cidades e municípios que os implementam. Consequentemente, a sua adoção e implementação tem sido expressiva em vários países, particularmente naqueles em vias de desenvolvimento. Contrariamente ao que se passa com a democracia local, o orçamento participativo na sua dimensão do direito à cidade, é um aspeto ainda pouco explorado e estudado (Cabannes & Delgado 2015; Chigbu et al. 2017). O orçamento participativo é crucial para a forma como a descentralização contribui para a promoção de duas questões dos direitos humanos pertinentes nesta tese – direito à cidade e os respetivos direitos a planificação e desenvolvimento urbano. O objetivo desta tese de doutoramento é o de examinar, através dos orçamentos participativos, o papel social, económico e político dos cidadãos e dos diversos atores locais, na proteção e promoção do direito à cidade, à democracia local, ao desenvolvimento urbano e ao bem-estar social em Moçambique. As questões aqui discutidas levam-nos a questionar diversos conceitos e modelos, desde a perspetiva social e económica ao relacionamento político dos atores envolvidos. Nestes termos, pretende apurar-se de que modo o direito à participação nas questões locais é promovido e concedido a partir de inovações democráticas ascendentes (dos cidadãos em relação ao estado), e a sua interação com os mecanismos do estado (em relação aos cidadãos). Deste modo, recorre-se à uma abordagem baseada nos modelos transnacionais de participação cidadã concebido por Sintomer et al., (2012; 2013) e a escala de participação de Arnstein (1969), para descrever o grau de envolvimento dos cidadãos nos planos municipais e nos orçamentos participativos. Entretanto, foram conduzidos dois estudos de caso, a saber: a participação cidadã nos planos de desenvolvimento urbano no município da Maxixe no sul, e nos orçamentos participativos em Quelimane, no centro de Moçambique. Para os objetivos desta tese e a metodologia aqui proposta, a pesquisa consistiu em recolha de dados secundários e primários obtidos através da pesquisa-ação participativa, com o objetivo de apurar o papel dos atores locais de desenvolvimento e o grau do seu envolvimento nas questões locais em Maxixe e Quelimane. Para tal, observaram-se as dinâmicas locais através de participação em reuniões de consultas públicas. E, na sua analise, recorreu-se a teoria fundamentada nos dados do estudo de caso. Deste modo, o estudo conclui que, apesar do grande potencial emancipador dos orçamentos participativos em Moçambique e as ações objetivas de promoção do engajamento dos cidadãos no desenvolvimento urbano, o direito à participação na conceção, gestão e ''usufruto'' da vida na cidade não é universalmente garantido a todos os Moçambicanos. Isto ocorre sobretudo porque os mecanismos locais de participação tendem a ser estratificados com base em assimetrias territoriais. Desta forma, como resultado da não participação cidadã, é evidente a existência de descontentamento social e de um potencial conflito de interesses que pode resultar num total descrédito dos cidadãos em relação as instituições democráticas e aos seus incumbentes. Apesar da narrativa criada à volta do orçamento participativo em Moçambique estar ''sempre'' associada ao desenvolvimento económico, social, e político, na prática, apresenta evidências pouco significativas da sua ligação ao desenvolvimento urbano e ao direito à cidade. Por outro lado, constatam-se evidências da sua orientação para a modernização dos procedimentos internos da administração pública, aperfeiçoamento e reforço da partilha de poder pelos atores locais. Por conseguinte, o envolvimento dos cidadãos nas questões locais é restrito ao âmbito de uma consulta pública frágil, que legitima os planos e as atividades dos governos locais. Deste modo, a participação pública em Moçambique está longe de garantir plenos direitos aos cidadãos. ; Tokyo Foundation; The Nippon Foundation; Sylff Scholarship; Governo do Distrito da Massinga (Moçambique); Cáritas de Coimbra
Load models play an essential role in many studies, including calculating voltage drops and technical losses in distribution systems, for distributed generator (DG) integration planning, and in tariff analysis and design models. The Herman-Beta transform used in the low voltage network modelling studies in South Africa is based on loads modelled as Beta probability density functions. Recently, the transform was extended to make it useful also for probabilistic load flow modelling in medium voltage (MV) networks with non-unity power factor loads and DGs. The electricity supply industry in South Africa has transformed and saw an increased penetration of Independent Power Producers as a result of the government encouraged the renewable independent power procurement programme (REIPPP). There has also been a steady decrease in the costs of procuring power from renewable energy sources, mainly from photovoltaic (PV) systems. South Africa also saw significant tariff increases in the recent past. These have resulted in both new load patterns and uncertainties in the power systems inputs required for network planning and tariff development. Other factors affecting loads and renewable energy output include weather, location and economic factors. Load models are essential for technical and tariff studies. Long term and short term planning models in both technical and tariff modelling require information about the usage behaviour of customers. Planning cannot be separated from the financial impact and tariffs in general. The literature review indicated that planning has the objective of designing a network for optimal usage, thus minimising the costs and deferring investment where possible. Load patterns have been recognised to represent the usage behaviours of customers better and these behaviours influence the planning parameters. There have been studies by numerous researchers to extract parameters from the load profiles for load flow modelling and simulation purposes. The same challenge exists for South Africa, where there has been progress made on the development of LV models, and the same is not replicated in the MV network space. The derivation of load models primarily involves the classification of loads, identifying and estimating the parameters of loads, and assigning load profiles to different loads for studies. Customer measurements are an essential input in load model development and load estimation. Identification of parameters is one of the areas where research is ongoing since there is no global consensus on which attributes best describe customer load profiles. In this study, a proposition on how the parameters for technical and tariff analysis models should be defined was made. The use of 24-hour load profiles to classify calendar days into typical days was also suggested. The availability of measurements data made it possible to develop load models for MV and conduct a study on actual customer data. The customers' measurements data, made it possible to identify the parameters and develop load models that could be used for technical and tariff analysis and conduct a pilot study to evaluate the load models. This study proposes a load model that can be used to model typical days and to model customer loads. The load models proposed here uses the k-means clustering algorithm as the basis for classification. The load models enable the classification of loads and assignment of load profiles accordingly. The results of this study indicated that load parameter models could be extracted from the customer measurements, for technical and tariff studies in distribution networks. It has also been possible to identify and determine the parameters from the load profiles and proposed a process for developing a load model for technical, economic and tariff analysis. The results also indicate that of the five identified parameters, the most significant parameters that affected the clustering results were the load factor, average power and the normalised peak usage parameter when the results of each of the factors were compared on an individual basis. The study also revealed improvements to the clustering results when all the parameters identified in this study were combined and a PCAbased clustering algorithm was used. Finally, the results indicate that the loads in the different economic activitybased classifications do not necessarily have similar shapes although they belong to the same cluster. The modelling process developed in this study may be implemented by utilities for determining load parameter models for MV feeders when measurements are available. The process may also be used to guide future data collection.
This research is a study of the Papua New Guinea (PNG) Liquefied Natural Gas (LNG) project, the country's biggest single investment in the extractive industry. The focus of the research is on understanding the impact and effect of the project on the country and in particular the distribution of the revenue and the influences on the distribution of the revenue. An additional area that was also looked at was the financial transparency and accountability of these distributions. The research arose in direct response to the fact that Papua New Guinea (PNG), which is well endowed with a wide range of natural resources, does not seem to use its natural wealth effectively to improve the human development of its people. The exploitation of these resources has in fact been associated with recurring fiscal and monetary crises, concentrations of investment in the minerals and petroleum sector, no improvement in the basic public services, and corruption at all levels of government. There has also been a persistent rising level of socio-economic inequality in the immediate communities hosting major resource projects and increasing poverty in the urban areas and pockets of rural areas. The research took a case study approach and used a multi-disciplinary lens by looking at the political, economic and anthropological literature and gleaning from them propositions about the influences on the distribution of revenues. In particular the case was used to investigate propositions related to the "resources curse" hypothesis that, in the absence of good governance, developing country governments are at risk to economic and fiscal mismanagement and corruption from the availability of resource rents from extractive industries. The research gathered evidence from people from project-specific documents made available largely through social media, accessible budget papers, parliamentary proceedings (Hansard), Acts of Parliament, government policy edicts, statements and press releases and websites of key government departments, state owned enterprises and the companies involved in the project, and some interviews of key informants. The Extractive Industry Transparency Initiative (EITI) reports on PNG were also specifically examined. The project has been exporting LNG now since 2014. While the construction of the project had a significant effect on economic growth, wages and prices and the exchange rate, the longer-term effects are more contestable. Returns to the economy and government revenues have been lower than forecast due to lower prices but also the effect of tax concessions and debt servicing leading to flows offshore larger than forecast. The government and landowners were making decisions based on a flawed projection and information to the extent that the government has been unable to sequester any revenues in a Sovereign Wealth Fund. Continued volatility in petroleum prices has affected government budget planning but overoptimistic forecasting of revenues including from the PNG (LNG) project, particularly in 2014-16, led to ballooning deficits. For short-term political reasons, government budgeting has tended to over-commit to new spending during the commodity booms and be forced in the downswings into cutbacks damaging to public services and investment or to rapid increases in broadly defined public debt. Budgets also pre-committed project revenues to new public expenditure project. The key point was the lack of attention being given to the downside risks of revenue projections supplied by the operator. The politics of access to resource rents have played out in the form of relations between local landholders and the government and in how the executive power has been able to structure access to project revenues nationally. The project also has had a destabilizing effect on local society where local-national relations have influenced the national politics of resource rent distribution and conversely have been put under pressure over contestation of the project impacts and access to benefits. Further, landholders have to date not received their full financial entitlements from the project despite the promises being made by successive governments since 2009. There has been ongoing discontent amongst landholders. The lack of transparency about the use of project revenues, particularly those not accruing directly to the Public Account, has contributed to this discontent. The research also found the few key project agreements have been officially released but much information has its way into the public domain via social media. Budget-related information has been more plentiful but the EITI has been hampered by poor financial reporting by public organisations receiving and managing revenues. When project information does enter the public and government is forced to acknowledge it, it can influence how government conducts its business and makes decisions.
The stereotyping of relations between Westernizers and Slavophiles, template view on representatives of both of them and those close to both of these circles, calling names like 'revolutionary democrat' and 'reactionary' are characteristic not only of Soviet history of Russian literature and public thought, but also of their foreign researchers. The most outstanding personalities in the history of Russian public and literary thought of the mid-19th century were Nikolai Gogol (1809-1852) and Vissarion Belinsky (1811-1848), known not only for their writings, but also for their correspondence with each other; they are more than anyone else who suffered from stereotyped approach to their ideas and personalities. In particular, among the contemporaries of Gogol and Belinsky, their correspondence of 1847 widely covered in the Russian press (including the Russian abroad) generated a lot of clichés. These clichés dominated in the Soviet school and circulate in modern Russian cultural-philosophical community. In my short paper, I aspire to consider well known dispute of 1847 between Belinsky and Gogol and both of their personalities using textual and philosophical hermeneutics analysis of both their correspondence and memoirs of their contemporaries. Thanks to Belinsky's ability, ones reckon Gogol in so-called 'natural school' that is a kind of realism, while already Russian philosopher Vasily Rozanov (1856-1919) stressed that Gogol's characters are fictitious and formal. However, Gogol is still seen as a critic of social reality. In this incorrect assessment, both revolutionaries who used Gogol's "criticism" to justify their violent and immoral activities, and liberals who seek to belittle and blacken Russian history and reality in every way, are of the same mind. Accordingly, the fact that Gogol burned the second part of his "Dead Souls" is often explained by his ideological cowardice and decline of his creativity, while the writer was a victim of his own mental illness and spiritual hardness of his spiritual mentor. Substantially, Gogol continued in Russian metaphysical thought, and new generation of Russian metaphysical thinkers, first of all, Dostoevsky, continued Gogol's literary and social-philosophical tradition. Another stereotype is related with perception of Belinsky as just about revolutionary-democrat and accomplished atheist. However, according to Belinsky do letters and memoirs of his contemporaries allow us to abandon such straightforward and unambiguous judgments. Belinsky appears as a developing personality whose views are influenced by various ideological preferences, especially Western European social and philosophical ideas, but Belinsky took these ideas quite critically. Despite his social pathos and demands for the immediate abolition of serfdom, Belinsky was not an adherent of overthrowing the monarchy. He was not also an atheist, although his religious beliefs were very peculiar and came close to Western European philosophical rationality. I conclude that personal predilections, ethical and aesthetic preferences of Belinsky, perceived a priori and brought to the logical limit, brought to the logical limit, became the banner of the revolutionary-democratic movement, and the victory of this movement in 1917 'canonized' Belinsky as an ideal of revolutionary and atheist. Meanwhile, neither he nor Gogol was supporters of radical (revolutionary) political changes, but both of them believed in future historical role and cultural mission of Russia. ; На примере известного спора В.Г. Белинского с Н.В. Гоголем, отталкиваясь от первоисточников (самой переписки 1847 г. и воспоминаний современников), а также литературной критики, была предпринята попытка преодоления отдельных стереотипов советской эпохи, бытующих до сих пор. Одним из таких стереотипов стало причисление Гоголя (с легкой руки Белинского) к так называемой «натуральной школе», своеобразному реализму, в то время как уже В. Розанов указывал на вымышленный и формальный характер персонажей Гоголя. В бытующей и поныне неправомерной оценке Гоголя как критика социальной действительности единодушны оказались как революционеры, использовавшие «критику» Гоголя для оправдания своей насильственной и аморальной деятельности, так и либералы, стремящиеся всячески принизить и очернить российскую историю и действительность, ее национальные идеалы. Другой стереотип связан с восприятием Белинского чуть ли не как революционера-демократа и законченного атеиста. Однако обращение к первоисточникам, прежде всего к письмам Белинского и воспоминаниям современников, позволяют отказаться от таких прямолинейных и однозначных суждений. Белинский предстает как развивающаяся личность, чьи взгляды испытывают воздействие различных идейных увлечений, прежде всего приходящих с Запада, воспринимаемых, тем не менее, критически. Однако хотя идеи Белинского подняла на щит и довела до логического конца исторически победившая революционно-демократическая общественность, в итоге приведшая страну к 1917 г., в то время как путь Гоголя продолжила русская метафизическая мысль, прежде всего Достоевский, обоих писателей волновали прежде всего культурно-историческое значение России и ее величие.
Efficient operations of state enterprises play a significant role in promoting development and growth of the national economy, and accordingly require implementing the most efficient model of governance. Given the state-seaport relation, current common concepts of port operations and their factors include features of Keynesian economic theory. Moreover, features of monetarism and institutionalism may be observed in the performance of seaports. The contrast between the assessment of seaport performance based on classical public administration and economic theories and the performance of the global maritime sector in modern market conditions raises the scientific problem of the research: Which methodology should be applied for comprehensive evaluation of added-value, created through the effective governance at the state seaport. The object of the research is the seaport governance. The aim of the research is to substantiate value oriented management changes of state seaport. The methods of the research include the following: systematic review, meta-analysis, analysis of scientific literature, logography, statistical analysis, interpretation, and generalization. Effective management consists of the following three managerial levels: operational management, strategical management, and governance. Each of latter management levels has different functional objectives and their consistent implementation creates the expected outcomes of effective management. The activities of state-owned companies are primarily based on their specific operational indicators, which create added value to the whole national economy. In order to achieve the highest possible added value, different management situations have to be modelled for the best solution to be found. According to the theory of public administration, especially related to the decentralization of state-owned enterprises, it is necessary to compare the indicators of financial efficiency and performance with the social and economic impact of the state-owned enterprises operating in the competitive market and region. The decentralization processes which occur due to the implementation of financial and institutional autonomy were implemented during the development of the new public management paradigm. At the end of the last century, many public management reforms were implemented in the area of infrastructure, transport and telecommunication management following the increase of the financial and institutional autonomy of state-owned enterprises. Such reforms were influenced by the shift of bureaucratic governance into corporate governance and following an increase of competitiveness in the market. Determining the effectiveness of seaport governance may indicate the level of complexity and linkages between the actors operating in the seaport and whole maritime transport sector. Moreover, the effectiveness of state-owned seaports may be evaluated and compared to other governance models by assessing the added value of activity and national socio-economic indicators. Economic theories provide a large variety of methodological approaches in defining and assessing performance. This responds to the tendency of the development of economic thought, related to the key differences between current economic schools and economic theory (postmodernist, free market, neoclassical, endogenous growth, etc.). It also promotes the need for forming a new research methodology, corresponding to modern economic development and operating environment, in order to reach a greater production and exchange efficiency, and social welfare maximization. In the eastern coast of the Baltic Sea, the ports of Estonia, Latvia and Lithuania compete with the ports of the Russian Federation. Comparing the main port activity indicator, the volume of cargo handling, the apparent trend of turnover of Lithuanian ports – cargo handling rate is lower than of the ports of the Russian Federation and is the largest in the Baltic states market. Based on the analysis of the results of Estonian, Latvian and Lithuanian ports, it can be argued that the positive and consistent improvement of the performance of the strategic object of the country, the state seaport, is a significant but insufficient indicator describing the country's social, economic and environmental situation. This confirms the theoretical statements that good macroeconomic indicators of various sectors of the state economy are not a precise unit of measurement of the current situation, do not adequately describe the actual economic situation of the country and do not meet the expectations of the population. In order to reflect the real socio-economic situation, it is necessary to follow the systematic conception of quality of life, which interprets the quality of life of the population as an integrated concept that fully describes the ecological, economic, material and moral health of society, measured at the macro level (national scale) and micro level (from the point of view of an individual).
In recent years there has been a booming and unguided 'modern' residential housing investments in most of the villages on the slopes of Mount Kilimanjaro, Tanzania. This was a phenomenon which motivated me to conduct this study in order to investigate the motives behind such investments, including the spatial and environmental challenges contribute by such investments. The idea is to conserve the nature in the villages on the slopes of Mount Kilimanjaro, including the mountain and its forest. The literature in Tanzania has shown that there have been inadequate studies carried out in the area of multi-locality and rural-urban linkage. This implies that, there is little knowledge known about multi-locational households, including their impacts, especially those which are related to housing investments in their villages of origin. This study has revealed that, the village housing investments as a socio-cultural motive of multi-locational households which is currently booming in the villages on the slopes of Mt. Kilimanjaro and of course in other villages in Tanzania is likely to, on the one hand; improve the village housing (reduce the housing poverty), increase village asset ownership, and enhance social status (prestige) at household, family and community levels. However, on the other hand and when not guided by the legal instruments and organs; it contributes to environmental challenges (e.g. over-exploitation of building materials such as timber, sand, bricks etc. causing deforestation and soil erosion) and spatial challenges (land fragmentation e.g. reduction of the farming land resulting from an excessive subdivision of the family land for housing investments). In understanding this problem, this study has employed both quantitative and qualitative approaches. The case study area (Sango Village) was the source of empirical evidence. The study has captured the socioeconomic and the qualitative data of 64 households who own 'modern' residential houses in Sango Village (it is one of the villages which lies on the slopes of mount Kilimanjaro). It was then followed by an in-depth interview of 8 multi-locational households who own 'modern' houses in Sango Village in order to capture their exceptional motives behind such investments. The information was also captured from the government officials and academics. Then, the analysis and interpretation of the data were done. The results have shown that, most of the 'modern' residential houses that we see in the villages on the slopes of Mount Kilimanjaro are because of multi-locational households. It has also been established that, there are significant and very convincing reasons/motives raised by multi-locational households on why they need to invest in 'modern' residential houses in their villages of origin. The motives behind such investments include: social status (prestige), event use (Christmas, Easter and burial ceremonies), culture to own a house in the village of origin, taking care of the elderly and a place to retire. This research has again shed light on the positive roles played by multi-locational households, especially in addressing the village housing poverty. It has further highlighted the spatial and environmental challenges resulting from the 'modern' residential housing investments in the villages on the slopes of Mount Kilimanjaro. The emerged challenges include: farming land transformation, scattered houses and cemeteries, accumulation of ghost houses, over exploitation of building materials causing deforestation and soil erosion. It is, therefore, argued that, in order to achieve more positive impacts than the negative ones, there are land and housing policies and institutional loopholes at the central and local government authorities that need urgent attention. For instance, the one that needs attention here include; the need of a provision of spatial planning and housing section/institution at the ward or village level. It is a hope that, this could be a better way of creating healthier and planned villages which are the towns and cities of tomorrow. This is possible if spatial planning becomes one of the central and local government priority areas. Again, this study has revealed that, the multi-locational households have positive and negative impacts in both the place of origin and destination. Thus, their inclusion in the development agenda, including in the population and housing census reports and curriculum in the universities is essential. In this way it will be easier to address their negative impacts in their villages of origin at the same time appreciate their positive impacts for the betterment of the village communities and the country at large.
The concept of character found its way into the study and discussion of leadership several years ago. Reasons for this emergence mentioned in the leadership literature ranged from corporate leadership scandals, such as the Enron, WorldCom, and Tyco debacles, the failures of many U.S. financial institutions, as well as ongoing concerns about the ethics of political leaders (Riggio, Zhu, Reina, & Maroosis, 2010). And there are other reasons, why character in leadership should not be neglected, neither in leadership research nor in practice. It co-determines the way leaders use their power (Bennis, 2007), their decision and actions while confronted with many ambiguous stimuli (Hambrick & Mason, 1984), the culture they create within their group of people they lead, serves as a role-model (not only) for ethical contexts, and may even affects the quality of the daily life of leaders' subordinates (Bennis, 2007). A view aspects of character can be found in different leadership concepts, amongst which are: Ethical Leadership (Brown & Treviño, 2006), Servant Leadership (Greenleaf, 1977), Authentic Leadership (George, 2003; Avolio & Gardner, 2005), Authentic Transformational Leadership (Bass & Steidlmeier, 1999), Spiritual Leadership (Fry, 2003), and Worthy Leadership (Thompson et al., 2008). However, until 2012 the systematic study of certain aspects of character—irrespective of any specific leadership concept—was still very rare. An exception was a study by Palanski and Yammarino (2011), which examined the effect of behavioral integrity on follower job performance. Given the wide-ranging gaps in this field of research, the present doctoral thesis addresses (1) the impact of various aspects of leaders' character on followers' attitudes and behavior towards their leader and work, (2) the moderating role of subordinates' personality regarding these relationships, (3) the incremental impact of these aspects above and beyond well-known leadership concepts, and (4) the distinction of different aspects of character regarding their relation to various outcome variables, especially one of the most important in leadership—followers' trust. In Study 1, 626 participants took part in a scenario experiment, in which the impact of three aspects of leaders' character (integrity, humility/forgiveness, and interest/gratitude) on followers' perceptions of the leader's worthiness of being followed (WBF), followers' organizational citizenship behavior (OCB), and followers' voice behavior has been examined. In addition, the moderating effects of followers' personality traits (agreeableness, conscientiousness, and neuroticism) were explored. Data from 626 participants of a scenario experiment supported the impact of leaders' character as well as the moderating impact of followers' personalities. Results showed that integrity, humility/forgiveness, and also leaders' interest/gratitude have a large impact on WBF, and a moderate to large impact on voice behavior, as well a small to moderate effect on OCB. In addition, the impact of integrity on WBF was moderated by participants' conscientiousness, humility/forgiveness on WBF was moderated by subordinates' agreeableness and neuroticism, and the impact of interest/gratitude on OCB was moderated by subordinates' neuroticism. In Study 2, the additional impact of leaders' integrity and humility/forgiveness above and beyond the impact of transformational leadership was under examination. Therefore, first a scenario experiment (N = 347) was performed. The results showed that integrity, as well as humility/forgiveness explained additional variance in WBF and participants anticipated stress, above and beyond transformational leadership. In a second sample an online survey study with 110 participants was conducted, in which the additional impact of integrity and humility/forgiveness on WBF and employees' perceived stress above and beyond the impact of transformational leadership could again be found. Regarding employees' perception of stress, only humility/forgiveness could explain variance, neither transformational leadership nor leaders' integrity did. Relative importance analyses showed that integrity and transformational leadership were equally important as predictors for WBF, whereas humility/forgiveness in comparison, was only half as important. In Study 3, the distinct impact of integrity and humility on subordinates' cognitive and affective trust was examined. The first sample (N = 254) showed by means of structural equation modeling, that integrity was primarily related to cognitive trust, and humility on affective trust. The second sample (N = 196) were conducted in order to replicate the findings from the first study with some methodical improvements. Again, integrity was found to be primarily related to cognitive trust, and humility to affective trust, whereas cognitive trust mediated the relation between integrity and affective trust. In conclusion, this doctoral thesis makes an important contribution to research on the impact of leaders' character on followers' attitudes and behavior towards their leader and work. Moreover, the gained insights permit several implications, reminding us that leaders' character cannot be left out of the equation, neither in leadership research nor in practice.
The necessity of proper analysis of the regional competitiveness concept brings the recognition. that the drivers of national competitiveness have become more local and the regions increasingly becoming the engines of the global economy, as the globalization blurs national borders. Furthermore, the regionalization of public policies moves the economic coordination and steering functions from the national state down to regional level.The topic of regional competitiveness is relevant in Lithuania also. Despite the fact, that the juristic base of regional policy is developed, it is still in conceptual stage. The developing of regional policy bristles with difficulties. therefore the efficiency of the policy is reducing and the economic and social differences among Lithuania's regions are increasing. The concept of regional policy and regional competitiveness become a subject to a great interest, especially implementing Eu rope Union financed projects in order to reduce the differences of development and increase the competitiveness of Lithuania's regions.The academic debate about regional competitiveness has been going on for several years, fuelled by critiques, but no consensus has arrived yet. There's still no theoretical perspective that captures the full complexity of regional competitiveness and assessment of it. Every academic creates his own regional competitiveness model and theoretically and empirically justify. As the concept of national competitiveness was analyzing by academics fur a long time and many models of national competitiveness are already formed, the theoretical analysis of these models in the context of regional competitiveness measurement would improve understanding of regional competitiveness and identify the methodological principals and suggestions of tbe assessment of regional competitiveness.The aim of the research is to analyze the models of national competitiveness in the context of regional competitiveness and identify the methodological principal, and suggestions of regional competitiveness measurement.Object .r the re.eareh is the abilities of national competitiveness models in the measurement the regional competitiveness.Methods of the research - analysis and synthesis of the scientific literature, logical and comparative analysis.The theoretical analysis of national competitiveness models shows, that M. Porter "National Diamond" model, D. S. Cho "Nine factors" model, A. M. Rugman, J. R. D'Cruz and A. Verbeke "Double Diamond" model, M. Porter and D. S. Cho and H. C. Moon "Competitiveness Stage," models are the most comprehensive in the theoretical and empirical viewpoint.The authors of article accept M. Porter "National Diamond" model as methodological base of modeling national competitiveness but misdoubt its ability in the measurement of regional competitiveness.The authors of article accept A. M. Rugman, J. R. D'Cruz and A. Verbeke "Double Diamond" model a, methodological base of analyzing and modeling regional competitiveness. It's still not clear, which diamond would reflect regional, national and international competitiveness, so this model should be adapted to the specially of regions.The analysis of D. S. Cho "Nine factors" model shows that it is insufficient systemically justified. The lack of empirical analysis of this model misdoubts its ability in the measurement of national and regional competitiveness.The theoretical analysis of M. Porter and D. S. Cho and H. C. Moon "Competitiveness Stages" models define the importance of comparing the competitiveness among economically and socially similar regions.The national competitiveness models, analyzed in the article, are formed to analyze bigger or smaller counties, but not regions. The specific of regions do not allow to adapt directly these models to the measurement of regions competitiveness, but the methodological principals should be used in the process of me.suring regional competitiveness.The authors of the article suggest that the assessment of regional competitiveness should be based of these methodological principals:clearly identify the factors of regional competitiveness and the relation among each other and the impact to overall competitiveness;to use the indicators, that is not dependent on the shift of economic cycle;to group the regions by one criteria and compare among each other similar regions;In order to measure the regional competitiveness, the internal and external factors of regional competitiveness should be identified, the specialty of regions should be defined and the theoretically and logically justified model of competitiveness should be created. ; Straipsnyje analizuojami bendrieji šalies konkurencingumo modeliai regionų aspektu bei moksliniai darbai, kuriuose empiriškai vertinamas regionų konkurencingumas. Išskirti šalies konkurencingumo modelių pranašumai ir trūkumai išryškino regionų konkurencingumo vertinimo sudėtingumą ir kompleksiškumą. Mokslinėje literatūroje paskelbtų konkurencingumo koncepcijų ir empirinių tyrimų sisteminė, loginė ir lyginamoji analizė leido išskirti metodologinius principus ir siūlymus, taikytinus vertinant regionų konkurencingumą bei pabrėžė teoriškai pagrįsto ir susisteminto regionų konkurencingumo modelio svarbą atliekant konkurencingumo vertinimą.
