Suchergebnisse

Energy transitions are a complex technological-economic and social process. Currently, this involves the impact that innovation in technology and information as well as social practices can have on the way the energy is used. Therefore, business becomes much more complex and risky. In the particular case of the European Union, recent years were also marked by multiple changes at the political, economic, social and environmental context. Changes are already in course posing new challenges to European Electricity Utilities. The question that arises is how these subjects impact the structure, consolidation and governance of the electricity utilities and which drivers have the greatest impact on the speeding up the change. It is also our aim to understand how companies are responding to transition challenges in order to ensure the sustainability of their activities and their healthy stay in the market. In this article we present an insight of this issue through the analysis of thirteen indicators on the seven largest European energy utilities. Results allowed comprising the effects of the different economic and financial contexts on the variables under study. ; info:eu-repo/semantics/publishedVersion

To describe the characteristics and management of Diabetes mellitus (DM) patients from low- and middle-income countries (LMIC). We systematically characterized consecutive DM patients attending public health services in urban settings in Indonesia, Peru, Romania and South Africa, collecting data on DM treatment history, complications, drug treatment, obesity, HbA1c, and cardiovascular risk profile; and assessing treatment gaps against relevant national guidelines. Patients (median 59 years, 62.9% female) mostly had type 2 diabetes (96%), half for >5 years (48.6%). Obesity (45.5%) and central obesity (females 84.8%; males 62.7%) were common. The median HbA1c was 8.7% (72 mmol/mol), ranging from 7.7% (61 mmol/mol; Peru) to 10.4% (90 mmol/mol; South Africa). Antidiabetes treatment included metformin (62.6%), insulin (37.8%), and other oral glucose-lowering drugs (34.8%). Disease complications included eyesight problems (50.4%), EGFR <60 ml/min (18.9%), heart disease (16.5%), and proteinuria (14.7%). Many had an elevated cardiovascular risk with elevated blood pressure (36%), LDL (71.0%), and smoking (13%), but few were taking antihypertensive drugs (47.1%), statins (28.5%) and aspirin (30.0%) when indicated. Few patients on insulin (8.0%), statins (8.4%) and antihypertensives (39.5%) reached treatment targets according to national guidelines. There were large differences between countries in terms of disease profile and medication use. DM patients in government clinics in four LMIC with considerable growth of DM have insufficient glycemic control, frequent macrovascular and other complications, and insufficient preventive measures for cardiovascular disease. These findings underline the need to identify treatment barriers and secure optimal DM care in such settings. This article is protected by copyright. All rights reserved.