828 resultados para external governance


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Peatlands play a crucial role in Indonesia's economic development, and in its stated goal of reducing greenhouse gas emissions. Improved peatland management - including a national moratorium on the granting of any new conversion licenses - forms a cornerstone of Indonesia's climate change mitigation commitment. At the same time, rapid expansion of the plantation sector is driving wide-scale drainage and conversion of peat swamp ecosystems. The province of Riau, in central Sumatra, finds itself at the crossroads of these conflicting agendas. This essay presents a case study of three islands on Riau's east coast affected by industrial timber plantation concessions. It examines the divergent experiences, perceptions and responses of communities on the islands. A mix of dramatic protests, localised everyday actions and constructive dialogue has succeeded in delaying or perhaps halting one of the concessions, while negotiations and contestation with the other two continue. With the support of regional and national non-governmental organisations and local government, communities are pursuing alternative development strategies, including the cultivation of sago, which requires no peat drainage. While a powerful political economy of state and corporate actors shapes the contours of socio-environmental change, local social movements can alter trajectories of change, promoting incremental improvements and alternative pathways.

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The unusual mixed public-private structure of the urban bus market in the metropolitan area of Barcelona provides an interesting context in which to analyze the management challenges and opportunities of the partial privatization of public services. Initiatives used by the public regulator to promote competition for contracts, such as short term concessions to private contractors and the removal of entry barriers, have considerable potential for improving efficiency and quality. The growth in the share of routes managed by private firms in recent years shows that privatization is a credible threat that may well stimulate improved performance among public managers. The type of reform implemented in Barcelona is of interest to all metropolitan areas large enough to operate under constant returns to scale regimes, and suitable for potential concessions of routes in segregated areas inside the metropolitan area, so as not to miss out on the benefits of economies of density.

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This brief conclusion suggests that, although governance is an important goal for sport organizations, it must be applied by taking into consideration the type of sport organizations, in particular whether the organization is an association of moral or physical persons and whether these persons are direct beneficiaries or not of the organization.

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BACKGROUND AND PURPOSE: The Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN) score was developed recently for predicting stroke-associated pneumonia (SAP), one of the most common complications after stroke. The aim of the present study was to externally validate the ISAN score. METHODS: Data included in the Athens Stroke Registry between June 1992 and December 2011 were used for this analysis. Inclusion criteria were the availability of all ISAN score variables (prestroke independence, sex, age, National Institutes of Health Stroke Scale score). Receiver operating characteristic curves and linear regression analyses were used to determine the discriminatory power of the score and to assess the correlation between actual and predicted pneumonia in the study population. Separate analyses were performed for patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH). RESULTS: The analysis included 3204 patients (AIS: 2732, ICH: 472). The ISAN score demonstrated excellent discrimination in patients with AIS (area under the curve [AUC]: .83 [95% confidence interval {CI}: .81-.85]). In the ICH group, the score was less effective (AUC: .69 [95% CI: .63-.74]). Higher-risk groups of ISAN score were associated with an increased relative risk of SAP; risk increase was more prominent in the AIS population. Predicted pneumonia correlated very well with actual pneumonia (AIS group: R(2) = .885; β-coefficient = .941, P < .001; ICH group: R(2) = .880, β-coefficient = .938, P < .001). CONCLUSIONS: In our external validation in the Athens Stroke Registry cohort, the ISAN score predicted SAP very accurately in AIS patients and demonstrated good discriminatory power in the ICH group. Further validation and assessment of clinical usefulness would strengthen the score's utility further.

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This articles describes three models which played a key role in the evolution of the International Olympic Committee (IOC) and all the organizations which contribute to the staging of the Olympic Games and constitute the Olympic System, from its beginnings in 1894 to the present day. This evolution and the addition of many stakeholders has increased the complexity of the management of the Olympic System over the years from pure Olympic administration (when the IOC headquarters moved to Lausanne in 1915) to Olympic network governance which must take into consideration more than 24 types of stakeholders, including goverments and intergovernmental organizations.

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But de l'étude Un enregistrement spécifique EMG du sphincter strié urétral avec décharges répétitives et complexes ainsi que salves de décélération a été décrit comme pathognomonique du syndrome de Fowler, un trouble de la relaxation du sphincter strié urétral chez la femme jeune responsable d'une retention urinaire. Nous avons souhaité étudier la présence de cet enregistrement EMG spécifique chez la femme asymptomatique, ceci à différents moments du cycle menstruel. Matériel et Méthode Nous avons recruté des femmes volontaires saines âgées entre 20 et 40 ans, ayant un cycle hormonal régulier, et ne présentant aucun symptôme urinaire. Les critères d'exclusion étaient la presence d'une dysfonction mictionnelle, d'une infection urinaire, la grossesse, la prise d'une thérapie hormonale ou d'hormone contraceptive, une obésité et des antécédants d'intervention pelvienne. Nous avons procédé à deux enregistrements EMG du sphincter strié urétral des participantes éligibles, utilisant une aiguille concentrique, ceci dans la première phase du cycle (phase folliculaire) et dans la dernière phase du cycle (phase lutéale). Les taux sériques de progestérone et d'oestrogène étaient mesurés à chaque enregistrement. Résultats 15 participantes ont complété l'étude. L' enregistrement EMG du sphincter a été positif avec présence de décharges répétitives et de salves de décélération lors d'une ou des deux phases du cycle menstruel chez 8 participantes (53%). Trois participantes présentaient cet enregistrement spécifique lors des deux phases du cycle et cinq participantes présentaient cet enregistrement spécifique lors de la phase lutéale uniquement. Aucune femme ne présentait cet enregistrement spécifique en début de cycle uniquement. Il n'y avait pas de relation avec l'âge, la parité ou les taux hormonaux. Conclusions L'enregistrement EMG spécifique du sphincter strié urétral, avec décharges répétitives et salves de décélération, se retrouve chez une proportion élevée de femmes asymptomatiques. Il a été montré que ce tracé change lors du cycle menstruel, en étant retrouvé plus fréquemment dans la dernière phase du cycle. L'importance de cet enregistrement EMG dans l'étiologie de la retention urinaire de la femme jeune reste à éclaircir. Nous devons considérer que sa présence ne pose pas automatiquement un diagnostic de syndrome de Fowler chez la femme en rétention urinaire.

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Coronary bypass grafting remains the best option for patients suffering from multivessel coronary artery disease, and the saphenous vein is used as an additional conduit for multiple complete revascularizations. However, the long-term vein graft durability is poor, with almost 75% of occluded grafts after 10 years. To improve the durability, the concept of an external supportive structure was successfully developed during the last years: the eSVS Mesh device (Kips Bay Medical) is an external support for vein graft made of weft-knitted nitinol wire into a tubular form with an approximate length of 24 cm and available in three diameters (3.5, 4.0 and 4.5 mm). The device is placed over the outer wall of the vein and carefully deployed to cover the full length of the graft. The mesh is flexible for full adaptability to the heart anatomy and is intended to prevent kinking and dilatation of the vein in addition to suppressing the intima hyperplasia induced by the systemic blood pressure. The device is designed to reduce the vein diameter of about 15-20% at most to prevent the vein radial expansion induced by the arterial blood pressure, and the intima hyperplasia leading to the graft failure. We describe the surgical technique for preparing the vein graft with the external saphenous vein graft support (eSVS Mesh) and we share our preliminary clinical results.

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We present a retrospective study on 22 operations of exostosis of the external auditory canal in 20 patients. 8 patients were passionated by water sports. The most frequent indication for surgery (13 operations) was recurrent external otitis or ceruminal obstruction. In 7 cases the need for a wider access to the middle ear indicated surgery. Surgery was usually performed as an outpatient procedure, maximum hospitalization was 3 days. The mean healing period was 6 (3-10) weeks. Mean follow up was 43 (3-110) months. There were no severe intraoperative complications such as facial paresis, lesions of the ossicles or of the inner ear. As intraoperative complications we found 2 perforations of the tympanic membrane, 2 expositions of the capsule of the mandibular joint, one of which was followed by chronic pain. As postoperative complications we found an early soft tissue stenosis of the external auditory canal and one late soft tissue stenosis which recurred after revision surgery. No recurrence of exostosis was seen. We describe an up to now unknown complication: the appearance of bilateral petrositis caused by staphylococcus epidermidis after bilateral surgery in an otherwise healthy patient. This study confirms that severe complications are rare, minor ones however relatively common. And that also minor complications may have a troublesome follow. Therefore and because of the potential of severe complications indication for surgery must be made cautiously and risks of the operation must not be underestimated.

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There is a lack of studies on tourism demand in Catalonia. To fill the gap, this paper focuses on detecting the macroeconomic factors that determine tourism demand in Catalonia. We also analyse the relation between these factors and tourism demand. Despite the strong seasonal component and the outliers in the time series of some countries, overnight stays give a better indication of tourism demand in Catalonia than the number of tourists. The degree of linear association between the macroeconomic variables and tourism demand is also higher when using quarterly rather than monthly data. Finally, there are notable differences between the results obtained for the different countries analysed. These results indicate that the best way to model tourism demand in Catalonia is to specify a quarterly model of overnight stays, differentiating between an aggregate demand model for the total number of tourists and specific models for each of the countries analysed.

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We examine the impact of governance mode and governance fit on performance in make-or-ally decisions. We argue that while horizontal collaboration and autonomous governance have direct and countervailing performance implications, the alignment of make-or-ally choices with the focal firm's resource endowment and the activity's resource requirements leads to better performance. Data on the aircraft industry show that relative to aircraft developed autonomously, collaborative aircraft exhibit greater sales but require longer time-to-market. However, governance fit increases unit sales and reduces time-to-market. We contribute to the alliance and economic organization literatures. (Copyright © 2013 John Wiley & Sons, Ltd.)

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How do processes of power shape the urban environment in small Indian cities? On a day-to-day basis, who actually controls access to and the use of environmental resources? How is this done? Answering these questions contributes to our ability to develop a nuanced understanding the urban condition. In order to investigate these questions an actor-oriented approach is developed, drawing on the anthropological literatures on everyday governance and the everyday state. This conceptual framework informs an urban political ecology approach oriented towards everyday practices and the micro-politics of the (re)production of urban socio-natures. This thesis employs a mixed methods approach to qualitative research. Three cases are presented to explore: para (neighbourhood) clubs as governance actors, the governance of the urban pondscape, and the urban political ecology of solid waste management. These case studies serve to highlight how power shapes the (re)production of urban socio-natures through the everyday environmental governance practices of a complex network of governance actors. This work further demonstrates how multiple intersectionalities, including class, caste and access to political and social authority, shape these practices and their outcomes. Finally, the manner in which balances of power, place making and the formation of subject positions may both result from and shape everyday environmental governance practices and their outcomes is explored. This empirical investigation makes a number of contributions to the literature. It has explores the hereto-understudied topics of environmental governance in small cities in India, the urban political ecologies of non-piped water and of solid waste, and the role of clubs as governance actors. It further contributes to conversations within the literature on how to deepen and broaden Urban Political Ecology by engaging with everyday practices, and cases of ordinary, not-openly contested socio-natures. -- Comment les processus de pouvoir influencent-ils l'environnement urbain dans les petites villes indiennes ? Au quotidien, qui contrôle l'accès et l'utilisation des ressources environnementales ? Comment ce contrôle s'exerce-t-il ? Répondre à ces questions contribue au développement d'une compréhension nuancée de la condition urbaine. Afin d'explorer ces questions une approche actor-oriented de la gouvernance quotidienne est développée, faisant appel aux littératures anthropologiques de la gouvernance quotidienne et de l'everyday state. Ce cadre conceptuel établit ainsi une approche d'Urban Political Ecology orientée vers les pratiques quotidiennes et la micro- politique de la (re) production des socio-natures urbaines. Cette thèse emploie des méthodes qualitatives mixtes. Trois cas sont présentés afin d'étudier : les clubs para (quartier) comme acteurs de la gouvernance; la gouvernance de la pondscape urbaine; et l'urban political ecology de la gestion des déchets solides. Ces études de cas permettent de mettre en lumière la façon dont le pouvoir influence la (re)production des socio-natures urbaines par le biais des pratiques quotidiennes de gouvernance environnementale d'un réseau complexe d'acteurs. Ce travail démontre également comment plusieurs intersectionnalités, y compris la classe, la caste et l'accès au pouvoir politique et social, façonnent ces pratiques de gouvernance et leurs produits. Finalement, cette recherche explore la manière dont les équilibres de pouvoir, la fabrication de lieux et la formation de la position du sujet peuvent à la fois résulter de et contribuer à façonner les pratiques quotidiennes de gouvernance environnementale et leurs produits. Cette investigation empirique fait ainsi plusieurs contributions à la littérature. Elle explore les questions jusque-là sous-étudiées de la gouvernance environnementale dans les petites villes en Inde, de l'urban political ecology de l'eau non courante et des déchets solides, ainsi que du rôle des clubs comme acteurs de la gouvernance. Celle-ci contribue également à des débats sur la façon d'approfondir et d'élargir l'urban political ecology en travaillant sur les pratiques quotidiennes, et sur des cas de socio-natures ordinaires, pas ouvertement contestées.