Dynamics in the governance of collective irrigation systems: Evidence from field experiments in Nicaragua.

The objective of this study is to analyze the common pool resource appropriation and public good provisiondecisions in a dynamic setting, testing the differences in behavior and performance between lab and field subjects. We performeda total of 45 games in Nicaragua, including 88 villagers in rural communities and 92 undergraduate students. In order to analyze sequential decision making, we introduce a dynamic and asymmetric irrigation game that combines the typical social dilemmas associated to irrigation systems management.In addition, in 9 out of 22 villagers’ groups, we implemented a treatment that included the disclosure of subjects’ appropriation of the common pool resource. The results reveal that the provision of individuals’ appropriation level results in higher appropriation in subsequent rounds. In addition, the results show that non-treated villagers provide more public good than treated villagers but if compared with students the differences are not significant. The results also suggest that appropriation levels are below the Nash prediction of full appropriation, but above the social efficient level. This results in an efficiency loss in the game that can be explained to a large extent by individual decisions on appropriation and public good contribution and by group appropriation behavior.

A technological framework based on automatic messaging for improving adherence of diabetic patients

En todo el mundo se ha observado un crecimiento exponencial en la incidencia de enfermedades crónicas como la hipertensión y enfermedades cardiovasculares y respiratorias, así como la diabetes mellitus, que causa un número de muertes cada vez mayor en todo el mundo (Beaglehole et al., 2008). En concreto, la prevalencia de diabetes mellitus (DM) está aumentando de manera considerable en todas las edades y representa un serio problema de salud mundial. La diabetes fue la responsable directa de 1,5 millones de muertes en 2012 y 89 millones de años de vida ajustados por discapacidad (AVAD) (OMS, 2014). Uno de los principales dilemas que suelen asociarse a la gestión de EC es la adherencia de los pacientes a los tratamientos, que representa un aspecto multifactorial que necesita asistencia en lo relativo a: educación, autogestión, interacción entre los pacientes y cuidadores y compromiso de los pacientes. Medir la adherencia del tratamiento es complicado y, aunque se ha hablado ampliamente de ello, aún no hay soluciones “de oro” (Reviews, 2002). El compromiso de los pacientes, a través de la participación, colaboración, negociación y a veces del compromiso firme, aumentan las oportunidades para una terapia óptima en la que los pacientes se responsabilizan de su parte en la ecuación de adherencia. Comprometer e involucrar a los pacientes diabéticos en las decisiones de su tratamiento, junto con expertos profesionales, puede ayudar a favorecer un enfoque centrado en el paciente hacia la atención a la diabetes (Martin et al., 2005). La motivación y atribución de poder de los pacientes son quizás los dos factores interventores más relevantes que afectan directamente a la autogestión de la atención a la diabetes. Se ha demostrado que estos dos factores desempeñan un papel fundamental en la adherencia a la prescripción, así como en el fomento exitoso de un estilo de vida sana y otros cambios de conducta (Heneghan et al., 2013). Un plan de educación personalizada es indispensable para proporcionarle al paciente las herramientas adecuadas que necesita para la autogestión efectiva de la enfermedad (El-Gayar et al. 2013). La comunicación efectiva es fundamental para proporcionar una atención centrada en el paciente puesto que influye en las conductas y actitudes hacia un problema de salud ((Frampton et al. 2008). En este sentido, la interactividad, la frecuencia, la temporalización y la adaptación de los mensajes de texto pueden promover la adherencia a un régimen de medicación. Como consecuencia, adaptar los mensajes de texto a los pacientes puede resultar ser una manera de hacer que las sugerencias y la información sean más relevantes y efectivas (Nundy et al. 2013). En este contexto, las tecnologías móviles en el ámbito de la salud (mHealth) están desempeñando un papel importante al conectar con pacientes para mejorar la adherencia a medicamentos recetados (Krishna et al., 2009). La adaptación de los mensajes de texto específicos de diabetes sigue siendo un área de oportunidad para mejorar la adherencia a la medicación y ofrecer motivación a adultos con diabetes. Sin embargo, se necesita más investigación para entender totalmente su eficacia. Los consejos de texto personalizados han demostrado causar un impacto positivo en la atribución de poder a los pacientes, su autogestión y su adherencia a la prescripción (Gatwood et al., 2014). mHealth se puede utilizar para ofrecer programas de asistencia de autogestión a los pacientes con diabetes y, al mismo tiempo, superar las dificultades técnicas y financieras que supone el tratamiento de la diabetes (Free at al., 2013). El objetivo principal de este trabajo de investigación es demostrar que un marco tecnológico basado en las teorías de cambios de conducta, aplicado al campo de la mHealth, permite una mejora de la adherencia al tratamiento en pacientes diabéticos. Como método de definición de una solución tecnológica, se han adoptado un conjunto de diferentes técnicas de conducta validadas denominado marco de compromiso de retroacción conductual (EBF, por sus siglas en inglés) para formular los mensajes, guiar el contenido y evaluar los resultados. Los estudios incorporan elementos del modelo transteórico (TTM, por sus siglas en inglés), la teoría de la fijación de objetivos (GST, por sus siglas en inglés) y los principios de comunicación sanitaria persuasiva y eficaz. Como concepto general, el modelo TTM ayuda a los pacientes a progresar a su próxima fase de conducta a través de mensajes de texto motivados específicos y permite que el médico identifique la fase actual y adapte sus estrategias individualmente. Además, se adoptan las directrices del TTM para fijar objetivos personalizados a un nivel apropiado a la fase de cambio del paciente. La GST encierra normas que van a ponerse en práctica para promover la intervención educativa y objetivos de pérdida de peso. Finalmente, los principios de comunicación sanitaria persuasiva y eficaz aplicados a la aparición de los mensajes se han puesto en marcha para aumentar la efectividad. El EBF tiene como objetivo ayudar a los pacientes a mejorar su adherencia a la prescripción y encaminarlos a una mejora general en la autogestión de la diabetes mediante mensajes de texto personalizados denominados mensajes de retroacción automáticos (AFM, por sus siglas en inglés). Después de una primera revisión del perfil, consistente en identificar características significativas del paciente basadas en las necesidades de tratamiento, actitudes y conductas de atención sanitaria, el sistema elige los AFM personalizados, los aprueba el médico y al final se transfieren a la interfaz del paciente. Durante el tratamiento, el usuario recopila los datos en dispositivos de monitorización de pacientes (PMD, por sus siglas en inglés) de una serie de dispositivos médicos y registros manuales. Los registros consisten en la toma de medicación, dieta y actividad física y tareas de aprendizaje y control de la medida del metabolismo. El compromiso general del paciente se comprueba al estimar el uso del sistema y la adherencia del tratamiento y el estado de los objetivos del paciente a corto y largo plazo. El módulo de análisis conductual, que consiste en una serie de reglas y ecuaciones, calcula la conducta del paciente. Tras lograr el análisis conductual, el módulo de gestión de AFM actualiza la lista de AFM y la configuración de los envíos. Las actualizaciones incluyen el número, el tipo y la frecuencia de mensajes. Los AFM los revisa periódicamente el médico que también participa en el perfeccionamiento del tratamiento, adaptado a la fase transteórica actual. Los AFM se segmentan en distintas categorías y niveles y los pacientes pueden ajustar la entrega del mensaje de acuerdo con sus necesidades personales. El EBF se ha puesto en marcha integrado dentro del sistema METABO, diseñado para facilitar al paciente diabético que controle sus condiciones relevantes de una manera menos intrusiva. El dispositivo del paciente se vincula en una plataforma móvil, mientras que una interfaz de panel médico permite que los profesionales controlen la evolución del tratamiento. Herramientas específicas posibilitan que los profesionales comprueben la adherencia del paciente y actualicen la gestión de envíos de AFM. El EBF fue probado en un proyecto piloto controlado de manera aleatoria. El principal objetivo era examinar la viabilidad y aceptación del sistema. Los objetivos secundarios eran también la evaluación de la eficacia del sistema en lo referente a la mejora de la adherencia, el control glucémico y la calidad de vida. Se reclutaron participantes de cuatro centros clínicos distintos en Europa. La evaluación del punto de referencia incluía datos demográficos, estado de la diabetes, información del perfil, conocimiento de la diabetes en general, uso de las plataformas TIC, opinión y experiencia con dispositivos electrónicos y adopción de buenas prácticas con la diabetes. La aceptación y eficacia de los criterios de evaluación se aplicaron para valorar el funcionamiento del marco tecnológico. El principal objetivo era la valoración de la eficacia del sistema en lo referente a la mejora de la adherencia. En las pruebas participaron 54 pacientes. 26 fueron asignados al grupo de intervención y equipados con tecnología móvil donde estaba instalado el EBF: 14 pacientes tenían T1DM y 12 tenían T2DM. El grupo de control estaba compuesto por 25 pa cientes que fueron tratados con atención estándar, sin el empleo del EBF. La intervención profesional tanto de los grupos de control como de intervención corrió a cargo de 24 cuidadores, entre los que incluían diabetólogos, nutricionistas y enfermeras. Para evaluar la aceptabilidad del sistema y analizar la satisfacción de los usuarios, a través de LimeSurvey, se creó una encuesta multilingüe tanto para los pacientes como para los profesionales. Los resultados también se recopilaron de los archivos de registro generados en los PMD, el panel médico profesional y las entradas de la base de datos. Los mensajes enviados hacia y desde el EBF y los archivos de registro del sistema y los servicios de comunicación se grabaron durante las cinco semanas del estudio. Se entregaron un total de 2795 mensajes, lo que supuso una media de 107,50 mensajes por paciente. Como se muestra, los mensajes disminuyen con el tiempo, indicando una mejora global de la adherencia al plan de tratamiento. Como se esperaba, los pacientes con T1DM recibieron más consejos a corto plazo, en relación a su estado. Del mismo modo, al ser el centro de T2DM en cambios de estilo de vida sostenible a largo plazo, los pacientes con T2DM recibieron más consejos de recomendación, en cuanto a dietas y actividad física. También se ha llevado a cabo una comparación de la adherencia e índices de uso para pacientes con T1DM y T2DM, entre la primera y la segunda mitad de la prueba. Se han observado resultados favorables para el uso. En lo relativo a la adherencia, los resultados denotaron una mejora general en cada dimensión del plan de tratamiento, como la nutrición y las mediciones de inserción de glucosa en la sangre. Se han llevado a cabo más estudios acerca del cambio a nivel educativo antes y después de la prueba, medidos tanto para grupos de control como de intervención. Los resultados indicaron que el grupo de intervención había mejorado su nivel de conocimientos mientras que el grupo de control mostró una leve disminución. El análisis de correlación entre el nivel de adherencia y las AFM ha mostrado una mejora en la adherencia de uso para los pacientes que recibieron los mensajes de tipo alertas, y unos resultados no significativos aunque positivos relacionados con la adherencia tanto al tratamiento que al uso correlacionado con los recordatorios. Por otra parte, los AFM parecían ayudar a los pacientes que no tomaban suficientemente en serio su tratamiento en el principio y que sí estaban dispuestos a responder a los mensajes recibidos. Aun así, los pacientes que recibieron demasiadas advertencias, comenzaron a considerar el envío de mensajes un poco estresante. El trabajo de investigación llevado a cabo al desarrollar este proyecto ofrece respuestas a las cuatro hipótesis de investigación que fueron la motivación para el trabajo. • Hipótesis 1 : es posible definir una serie de criterios para medir la adherencia en pacientes diabéticos. • Hipótesis 2: es posible diseñar un marco tecnológico basado en los criterios y teorías de cambio de conducta mencionados con anterioridad para hacer que los pacientes diabéticos se comprometan a controlar su enfermedad y adherirse a planes de atención. • Hipótesis 3: es posible poner en marcha el marco tecnológico en el sector de la salud móvil. • Hipótesis 4: es posible utilizar el marco tecnológico como solución de salud móvil en un contexto real y tener efectos positivos en lo referente a indicadores de control de diabetes. La verificación de cada hipótesis permite ofrecer respuesta a la hipótesis principal: La hipótesis principal es: es posible mejorar la adherencia diabética a través de un marco tecnológico mHealth basado en teorías de cambio de conducta. El trabajo llevado a cabo para responder estas preguntas se explica en este trabajo de investigación. El marco fue desarrollado y puesto en práctica en el Proyecto METABO. METABO es un Proyecto I+D, cofinanciado por la Comisión Europea (METABO 2008) que integra infraestructura móvil para ayudar al control, gestión y tratamiento de los pacientes con diabetes mellitus de tipo 1 (T1DM) y los que padecen diabetes mellitus de tipo 2 (T2DM). ABSTRACT Worldwide there is an exponential growth in the incidence of Chronic Diseases (CDs), such as: hypertension, cardiovascular and respiratory diseases, as well as diabetes mellitus, leading to rising numbers of deaths worldwide (Beaglehole et al. 2008). In particular, the prevalence of diabetes mellitus (DM) is largely increasing among all ages and constitutes a major worldwide health problem. Diabetes was directly responsible for 1,5 million deaths in 2012 and 89 million Disability-adjusted life year (DALYs) (WHO 2014). One of the key dilemmas often associated to CD management is the patients’ adherence to treatments, representing a multi-factorial aspect that requires support in terms of: education, self-management, interaction between patients and caregivers, and patients’ engagement. Measuring adherence is complex and, even if widely discussed, there are still no “gold” standards ((Giardini et al. 2015), (Costa et al. 2015). Patient’s engagement, through participation, collaboration, negotiation, and sometimes compromise, enhance opportunities for optimal therapy in which patients take responsibility for their part of the adherence equation. Engaging and involving diabetic patients in treatment decisions, along with professional expertise, can help foster a patient-centered approach to diabetes care (Martin et al. 2005). Patients’ motivation and empowerment are perhaps the two most relevant intervening factors that directly affect self-management of diabetes care. It has been demonstrated that these two factors play an essential role in prescription adherence, as well as for the successful encouragement of a healthy life-style and other behavioural changes (Heneghan et al. 2013). A personalised education plan is indispensable in order to provide the patient with the appropriate tools needed for the effective self-management of the disease (El-Gayar et al. 2013). Effective communication is at the core of providing patient-centred care since it influences behaviours and attitudes towards a health problem (Frampton et al. 2008). In this regard, interactivity, frequency, timing, and tailoring of text messages may promote adherence to a medication regimen. As a consequence, tailoring text messages to patients can constitute a way of making suggestions and information more relevant and effective (Nundy et al. 2013). In this context, mobile health technologies (mHealth) are playing significant roles in improving adherence to prescribed medications (Krishna et al. 2009). The tailoring of diabetes-specific text messages remains an area of opportunity to improve medication adherence and provide motivation to adults with diabetes but further research is needed to fully understand their effectiveness. Personalized text advices have proven to produce a positive impact on patients’ empowerment, self-management, and adherence to prescriptions (Gatwood et al. 2014). mHealth can be used for offering self-management support programs to diabetes patients and at the same time surmounting the technical and financial difficulties involved in diabetes treatment (Free et al. 2013). The main objective of this research work is to demonstrate that a technological framework, based on behavioural change theories, applied to mHealth domain, allows improving adherence treatment in diabetic patients. The framework, named Engagement Behavioural Feedback Framework (EBF), is built on top of validated behavioural techniques to frame messages, guide the definition of contents and assess outcomes: elements from the Transtheoretical Model (TTM), the Goal-Setting Theory (GST), Effective Health Communication (EHC) guidelines and Principles of Persuasive Technology (PPT) were incorporated. The TTM helps patients to progress to a next behavioural stage, through specific motivated text messages, and allow clinician’s identifying the current stage and tailor its strategies individually. Moreover, TTM guidelines are adopted to set customised goals at a level appropriate to the patient’s stage of change. The GST was used to build rules to be applied for enhancing educational intervention and weight loss objectives. Finally, the EHC guidelines and the PPT were applied to increase the effectiveness of messages. The EBF aims to support patients on improving their prescription adherence and persuade them towards a general improvement in diabetes self-management, by means of personalised text messages, named Automatic Feedback Messages (AFM). After a first profile screening, consisting in identifying meaningful patient characteristics based on treatment needs, attitudes and health care behaviours, customised AFMs are selected by the system, approved by the professional, and finally transferred into the patient interface. During the treatment, the user collects the data into a Patient Monitoring Device (PMD) from a set of medical devices and from manual inputs. Inputs consist in medication intake, diet and physical activity, metabolic measurement monitoring and learning tasks. Patient general engagement is checked by estimating the usage of the system and the adherence of treatment and patient goals status in the short and the long term period. The Behavioural Analysis Module, consisting in a set of rules and equations, calculates the patient’s behaviour. After behavioural analysis is accomplished, the AFM library and the dispatch setting are updated by the AFM Manager module. Updates include the number, the type and the frequency of messages. The AFMs are periodically supervised by the professional who also participates to the refinement of the treatment, adapted to the current transtheoretical stage. The AFMs are segmented in different categories and levels and patients can adjust message delivery in accordance with their personal needs. The EBF was integrated to the METABO system, designed to facilitate diabetic patients in managing their disease in a less intrusive approach. Patient device corresponds in a mobile platform, while a medical panel interface allows professionals to monitoring the treatment evolution. Specific tools allow professional to check patient adherence and to update the AFMs dispatch management. The EBF was tested in a randomised controlled pilot. The main objective was to examine the feasibility and acceptance of the system. Secondary objectives were also the assessment of the effectiveness of system in terms of adherence improvement, glycaemic control, and quality of life. Participants were recruited from four different clinical centres in Europe. The baseline assessment included demographics, diabetes status, profile information, knowledge about diabetes in general, usage of ICT platforms, opinion and experience about electronic devices and adoption of good practices with diabetes. Acceptance and the effectiveness evaluation criteria were applied to evaluate the performance of the technological framework. The main objective was the assessment of the effectiveness of system in terms of adherence improvement. Fifty-four patients participated on the trials. Twenty-six patients were assigned in the intervention group and equipped with mobile where the EBF was installed: 14 patients were T1DM and 12 were T2DM. The control group was composed of 25 patients that were treated through a standard care, without the usage of the EBF. Professional’s intervention for both intervention and control groups was carried out by 24 care providers, including endocrinologists, nutritionists, and nurses. In order to evaluate the system acceptability and analyse the users’ satisfaction, an online multi-language survey, using LimeSurvey, was produced for both patients and professionals. Results were also collected from the log-files generated in the PMDs, the professional medical panel and the entries of the data base. The messages sent to and from the EBF and the log-files of the system and communication services were recorded over 5 weeks of the study. A total of 2795 messages were submitted, representing an average of 107,50 messages per patient. As demonstrated, messages decrease over time indicating an overall improvement of the care plan’s adherence. As expected, T1DM patients were more loaded with short-term advices, in accordance with their condition. Similarly, being the focus of T2DM on long-term sustainable lifestyle changes, T2DM received more reminders advices, as for diet and physical activity. Favourable outcomes were observed for treatment and usage adherences of the intervention group: for both the adherence indices, results denoted a general improvement on each care plan’s dimension, such as on nutrition and blood glucose input measurements. Further studies were conducted on the change on educational level before and after the trial, measured for both control and intervention groups. The outcomes indicated the intervention group has improved its level of knowledge, while the control group denoted a low decrease. The correlation analysis between the level of adherences and the AFMs showed an improvement in usage adherence for patients who received warnings message, while non-significantly yet even positive indicators related to both treatment and usage adherence correlated with the Reminders. Moreover, the AFMs seemed to help those patients who did not take their treatment seriously enough in the beginning and who were willing to respond to the messages they received. Even though, patients who received too many Warnings, started to consider the message dispatch to be a bit stressful. The research work carried out in developing this research work provides responses to the four research hypothesis that were the motivation for the work: •Hypothesis 1: It is possible to define a set of criteria to measure adherence in diabetic patients. •Hypothesis 2: It is possible to design a technological framework, based on the aforementioned criteria and behavioural change theories, to engage diabetic patients in managing their disease and adhere to care plans. •Hypothesis 3: It is possible to implement the technological framework in the mobile health domain. •Hypothesis 4: It is possible to use the technological framework as a mobile health solution in a real context and have positive effects in terms of diabetes management indicators. The verification of each hypothesis allowed us to provide a response to the main hypothesis: The Main Hypothesis is: It is possible to improve diabetic adherence through a mHealth technological framework based on behavioural change theories. The work carried out to answer these questions is explained in this research work. The framework was developed and applied in the METABO project. METABO is an R&D project, co-funded by the European Commission (METABO 2008) that integrates mobile infrastructure for supporting the monitoring, management, and treatment of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) patients.

El proyecto de vivienda como laboratorio de estrategias para Sejima y Nishizawa de 1987 a 2010

Como indica el título, esta tesis plantea el estudio de la arquitectura doméstica elaborada por los arquitectos japoneses Kazuyo Sejima y Ryue Nishizawa. Más concretamente, la investigación se ciñe a un conjunto integrado por veinticinco casas que los arquitectos proyectaron entre 1987, momento en el que Sejima establece su propia oficina, y 2010, fecha en la que el reconocimiento del trabajo que ambos venían desarrollando queda certificado a nivel internacional, ya que ese año son galardonados con el premio Pritzker y comisarían la Bienal deVenecia. Del estudio conjunto y sistemático de estos proyectos, y de sus distintas versiones se espera poder obtener una serie de criterios exegéticos que permitan comprenderlos y explicarlos mejor, relacionándolos entre sí de manera coherente. A estos criterios es a lo que hemos denominado estrategias. En el momento en el que se inicia esta investigación se detectó un vacío editorial respecto al tema tratado, apenas había textos, propios o ajenos que abordaran esta faceta de la obra de Sejima y Nishizawa en profundidad. No en vano, algunos críticos han acuñado el apelativo de "arquitectos sin palabras" para referirse, tanto a ellos como a la generación de arquitectos que la pareja encabeza, dando a entender que se trata de una arquitectura carente de explicación.1 Sin embargo, esta investigación sostiene que el hecho de que los arquitectos no hablen en exceso de su obra y mantengan una actitud centrada en desarrollar de forma práctica su trabajo no quiere decir que prescindan de realizar operaciones compositivas altamente idealizadas y abstractas, refrendadas por un marco cultural y teórico que se pueda describir. Tras recopilar, ordenar y analizar un número lo suficientemente amplio como para ser significativo de las manifestaciones verbales que los arquitectos han realizado a lo largo del periodo estudiado, se ha observado que de entre todos los términos que los dos socios que integran SANAA emplean para describir sus proyectos, uno de los más relevantes y quizás también el más general resulta la palabra “sistema”.2 El modo en el que ambos describen los principios de su arquitectura, diferenciando entre los componentes del programa, y las relaciones que se establecen entre éstos, y entre ellos y el exterior permiten sostener que no se trata de un uso accidental término. Paralelamente, al mismo tiempo que se indaga sobre el corpus intelectual de esta teoría se intenta detallar las circunstancias que favorecieron tal trasvase de ideas entre Occidente y Japón y como acabaron llegando al ámbito de estos arquitectos. Al amparo de este marco teórico y tras redibujar las viviendas documentadas, se intentará describir los rasgos de la estructura material de las viviendas analizadas, así como cartografiar los patrones organizativos que las caracterizan. Para ello se empleará el rigor instrumental que aporta la teoría de grafos como método habitual para la representación, estudio y caracterización de sistemas. Los resultados de la investigación evidencian que hay una serie de estrategias — tanto materiales como organizativas— que enunciadas en sus primeros proyectos se van desarrollando en obras posteriores, conformado sistemas que están paulatinamente más organizados. Y que llegado un punto en la trayectoria de estos arquitectos, se observa que tales estrategias, se van superponiendo de distinta forma en diversos proyectos, por lo que es posible agruparlos y hablar de ellos atendiendo a características comunes. Finalmente, el estudio concluye que tanto a nivel material como reladonal, bien podría decirse que en el periodo estudiado, las estrategias empleadas por Sejima y Nishizawa para elaborar su arquitectura doméstica persiguen un objetivo común que se fundamenta en la elaboración de planteamientos sintéticos que les permiten explorar y responder creativamente ante las disyuntivas previamente establecidas, precisamente explotando el potencial de las paradojas que las originan. ABSTRACT As the title suggest itself, this thesis deals about the study of domestic architecture developed by Japanese architects Kazuyo Sejima and Ryue Nishizawa. More specifically, research focus its attention on a group of twenty five houses that both architects projected from 1987, when Sejima establishes her own practice, and 2010, as the moment in which their work obtains international acknowledgment, since this year they are awarded the Pritzker prize and cúrate the Venice Biennale. From the combined and systematic study of all these projects, and their different versions are expected to obtain a series of exegetical criteria to relate to each other, understand and explain better. These criteria are what we cali strategies. By the time when this research began, an editorial emptiness about the treaty issue was detected; there were barely texts that addressed this aspect of the work of Sejima and Nishizawa in depth, neither the ones written by the architects themselves ñor by other authors. Some critics have coined the ñame "wordless generation" to refer to both them as to the generation of architects that the couple leads, implying that it is an architecture devoid of explanation.3 However, this study argües that the fact that architects do not speak too much about his work and keep themselves focused on developing practical work attitude does not mean that dispense perform highly idealized and abstract compositional operations, fueled by a frame cultural and theoretical that can be described. After collect, sort and analyze a large enough number of verbal statements done by the architects about their work as to be meaningful, it was observed that of all the terms that the two partners that intégrate SANAA used to describe their projects, one of the most important and, perhaps one of the most general, is the word "system".4 The way in which both describe the principies of their architecture distinguishing between program components and the relationships established between them, and between them and the outside allow us the view that it is not accidental use of a term. Similarly, while it investigates the intellectual corpus of this theory it attempts to explain some of the circumstances that favored such transfer of ideas between the West and Japan and how eventually reaching the scope of these architects. Under this framework and after redraw the documented houses we attempt to describe the characteristics of the material structure of the projects tested, as well as mapping the organizational patterns that characterize them. For this, we use the instrumental rigor that brings graph theory, as a regular method of representation, study and characterization of systems used. The research results show that there are a number of strategies -both material and organizational level- that once they are set out in its first projects are developed in later works. Bringing up systems that are gradually more and more organized. And at one point in the career of these architects, such strategies are observed, they are superimposed differently on various projects, making it possible to group them and discuss them according to common characteristics. Finally, the study condueles that both materially and organizational it could be said that in the period studied, the strategies employed by Sejima and Nishizawa to develop its domestic architecture pursue a common goal, which is based on the development of synthetic approaches that allow them explore and respond creatively to the previously established dilemmas precisely exploiting the paradoxical potential that originates them.

Direito, democracia e cultura digital: a experiência de elaboração legislativa do Marco Civil da Internet

Este trabalho tem como objeto de pesquisa o processo de consulta pública online para elaboração do Marco Civil da Internet, nova lei que dispõe sobre os direitos dos usuários de Internet no Brasil. Ele busca responder às seguintes perguntas: (i) como foi idealizado processo de consulta pública online do Marco Civil da Internet? (ii) Como a consulta foi gerenciada e executada? (iii) Quais foram os resultados da consulta em termos de soluções jurídicas aos conflitos políticos do setor da Internet? A proposta é realizar uma descrição desta experiência de participação social pela Internet a partir de um mapeamento das contribuições dos cidadãos e instituições, de informações em fontes variadas (imprensa especializada ou não e outros trabalhos acadêmicos) e do confronto deste levantamento com entrevistas dadas pelos gestores do projeto sobre seu planejamento e execução. A pesquisa trabalhou com a hipótese de que a consulta pública online que elaborou o Marco Civil da Internet se colocou como alternativa a um debate instaurado dentro do Congresso Nacional e bloqueado por propostas de lei de enfoque penal. O resultado da pesquisa sugere a confirmação dessa hipótese, bem como a relevância da experiência analisada para o sucesso uma estratégia política de reversão dessa agenda legislativa anterior.

O direito na teoria crítica dos sistemas: da justiça autossubversiva à crítica imanente do direito

O recente desenvolvimento de uma teoria crítica dos sistemas, de Gunther Teubner a Andreas Fischer-Lescano, abriu novos horizontes teóricos para aqueles que se propõe a estudar a sociedade e o sistema jurídico. A construção de uma teoria crítica sob condições sistêmicas possibilitou o uso conjunto de temas e conceitos teóricos provenientes da teoria crítica da primeira geração da Escola de Frankfurt (crítica imanente, antagonismos sociais, reificação, dialética do esclarecimento) e da teoria dos sistemas (paradoxo, sistema, sociedade mundial). Partindo disso, o sistema jurídico foi analisado nas dimensões da justiça (como fórmula contingente e transcendente) e de sua crítica imanente como atitude transcendente, especialmente em face de sua tendência em se autorreproduzir como ordem social reificada que gera injustiça pelos excessos de justiça. Para alcançar essas conclusões, este trabalho se propôs a analisar o cenário da sociedade moderna no qual nasce a teoria crítica dos sistemas (Parte 1), lançando bases para os aspectos estruturais e semânticos sobre os quais ela se apoia. Seguidamente, foram estabelecidos os pressupostos teóricos básicos da teoria crítica da Escola de Frankfurt e da teoria dos sistemas de Luhmann (Parte 2) com o fim específico de colher os elementos essenciais à construção de uma teoria crítica dos sistemas voltada para o estudo do sistema jurídico. Logrado esse ponto, focou-se a análise do sistema jurídico e de sua evolução até alcançar sua atual condição na forma de um direito global na sociedade fragmentada (Parte 3). A partir disso a justiça autossubversiva e a crítica imanente do direito foram abordadas em seus aspectos essenciais e possibilitadores de uma autotranscendência sistêmica, capaz de tornar o direito mais responsivo com relação ao seu ambiente, limitando a irracionalidade racional inerente a uma ordem social reificada. A presente dissertação propõe dar mais um passo no sentido do desenvolvimento de uma teoria crítica dos sistemas aplicada ao direito, diagnosticando os dilemas contemporâneos e ao mesmo tempo, apontando os desafios existentes numa sociedade mundial paradoxalmente marcada pela possibilidade de hipertrofia sistêmica das ordens sociais reificadas e pelos processos de constitucionalização que buscam limitar essas ordens.

Formação inicial de professores de química: o processo de reflexão orientada visando o desenvolvimento de práticas educativas no ensino médio

O Processo de Reflexão Orientada apresenta-se como uma nova proposta formativa, a qual pode contribuir para a formação inicial professores. Nesse processo, o futuro professor, mediado por um professor mais experiente, tem a oportunidade de elaborar e avaliar suas ideias sobre o ensino e a aprendizagem, suas metodologias e suas práticas de ensino, podendo clarificar e confrontar suas teorias pessoais. Neste sentido, este trabalho investigou as contribuições do PRO na atuação pedagógica de licenciandos em Química, visando um ensino por investigação e para a promoção da alfabetização científica no Ensino Médio. Para isso, mediados pela pesquisadora, os três licenciandos participantes da pesquisa elaboraram uma sequência de aulas e a desenvolveram em sala de aula, refletindo sobre suas concepções e práticas durante todo o processo envolvido. Diversas propostas de uma mesma sequência de aulas, sobre um mesmo conteúdo químico, foram elaborados pelos licenciandos, de forma a contemplar uma sequência investigativa e para promoção da AC. A última proposta foi aplicada em sala de aula. Os licenciandos avaliaram e refletiram sobre a sua prática em sala de aula e sobre os planos desenvolvidos, utilizando referenciais teóricos sobre ensino por investigação, AC e exigência cognitiva das questões. Para compreender a evolução dos licenciandos durante o PRO, a pesquisadora analisou os níveis investigativos dos elementos pedagógicos presentes nos planos elaborados e nas aulas ministradas por eles; o nível de AC dos planos e das aulas ministradas, bem como, o nível cognitivo das questões propostas nos planos e nas aulas. O processo reflexivo sobre a prática dos licenciandos é evidenciado por meio de categorias de análise e exemplificadas por trechos das transcrições dos encontros reflexivos realizados entre eles e a pesquisadora. As contribuições do grupo durante o processo também foram avaliadas. Os resultados mostram que os planos desenvolvidos pelos três licenciandos apresentaram evoluções na maioria dos tópicos avaliados, o que pode ser justificado pelas reflexões proporcionadas pelos encontros individuais e em grupo. No entanto, algumas dificuldades foram evidenciadas quanto a proposição da questão problema e de materiais para o levantamento das ideias prévias dos estudantes. A análise das aulas evidencia algumas dificuldades vivenciadas pelos licenciandos durante suas regências, como a sustentação da questão problema, bem como, das interações dialógicas. As reflexões realizadas entre a pesquisadora e os licenciandos, durante os encontros individuais, evidenciam momentos relevantes para a formação inicial, visto que os futuros professores expunham suas concepções, anseios e dilemas. Os encontros reflexivos em grupo também evidenciam contribuições, o que possibilitou ao grupo socializar, confrontar e compartilhar suas ideias e experiências. Esta pesquisa também mostra a importância do papel do mediador, já que a confiança dos licenciandos pela pesquisadora parece ter contribuído para o comprometimento deles durante o processo. Assim, o PRO vivenciado pelos licenciandos parece ter contribuído para eles desenvolverem uma postura crítica com relação à prática docente. Ao elaborar os planejamentos e avaliar suas ações, baseados em referenciais teóricos, puderam construir novas ideias sobre o processo de ensino e de aprendizagem em Química.

Padre que amava Moça que amava Carlos que amava Joaquim que amava. Dimensões histórico-críticas do diálogo entre o longa-metragem O padre e a moça (Joaquim Pedro de Andrade, 1965) e o poema \'O padre, a moça\' (Carlos Drummond de Andrade, 1962)

Este trabalho consiste em investigar as relações entre poética e contexto em duas obras: O padre e a moça (longa-metragem ficcional que Joaquim Pedro de Andrade finalizou em 1965), e o poema (de que Joaquim Pedro se apropria) O padre, a moça (publicado por Carlos Drummond de Andrade em Lição de coisas, de 1962). Como se trata de duas obras profundamente dialogais, a investigação sobre o caráter de empenho estético-ideológico orienta-se, evidentemente, pelo cotejo. O contexto dos 1960 (atravessado pelos dilemas da modernização capitalista dependente e periférica) revela-se fundamental para a compreensão de aspectos temático-formais de ambas as obras (uma, anterior ao Golpe de 1964, a outra, imediatamente posterior). A presença do contexto em ambos os textos, entretanto, exige a compreensão sobre as mediações propriamente artísticas. Para tanto, a pesquisa procura orientar-se pelo método de redução estrutural (desenvolvido por Antônio Candido); nem por isso, abre mão de refletir sobre seus pressupostos teórico-metodológicos (tomados à análise estética, mas também às reflexões sociológicas, historiográficas e filosóficas).

Incorporating Multiculturalism in Medical Decisional Capacity Assessment

As the demography of the U.S. population becomes increasingly older and culturally diverse, psychologists must develop greater multicultural competency and abilities to provide culturally and linguistically appropriate clinical services. This paper focuses on the dire need for the development of multicultural approach to medical decisional capacity evaluation. The purpose of this paper is to examine the common clinical and ethical dilemmas faced by psychologists when evaluating culturally diverse geriatric population. For instance, the lack of culturally and linguistically appropriate cognitive and functional assessment measures with sound reliability, validity, and normative properties is discussed in detail. This paper introduces possible solutions to the dilemmas and aims to ultimately contribute to increased multicultural awareness within the U.S. healthcare system.

Enfermería y antropología en Brasil: relaciones, dilemas y desafíos

Tomando como punto de partida la invisibilidad de la producción científica de enfermería, en la perspectiva antropológica, en las revisiones de la literatura sobre antropología de la salud en Brasil, el objetivo de este artículo es realizar un breve análisis crítico de la relación entre enfermería y antropología puntuando las particularidades del contexto brasileño en comparación con países como Estados Unidos, Gran Bretaña y España y, en especial, discutir los dilemas (problemas y límites) en las relaciones existentes entre las dos disciplinas y señalar algunos desafíos para su desarrollo y consolidación. Por último, los argumentos y análisis comparativo de la construcción de esta relación en los diferentes países permiten ver ciertas hipótesis que apuntan a contribuir a los futuros debates y estudios en Brasil.

Play the game or get played? Researchers’ strategies around R&D policies

This chapter focuses on possible effects of current R&D policies in the scientific work, exploring some of the dilemmas they cause to researchers. In a transnational scale, R&D policies embrace performance-based research funding systems, calling for a growing accountability and a more useful and published research. Often justified by the importance of knowledge in public policies or as part of the new managerialism regime, these trends emphasize performativity on research. In this scenario, how researchers receive and interpret R&D policies is influenced according to their values and interests? Do they play the game or do they get played by it? These questions rely on a conceptual framework that conceives the research as a political scene, where researchers and R&D policies meet. Moreover, researchers’ strategies are perceived as political, considering that it is in the context of the practices that policy is interpreted and reinvented. The chapter presents an empirical study conducted in Portugal, which will be taken as an example of what Waitere et al (2011) already named as “choosing whether to resist or reinforce” R&D policies. In fact, the study revealed a strategic calculation made by researchers and the coexistence of convergent and divergent strategies concerning R&D policies. I will argue that the tensions in this strategic game are both a reflex and generator of the dilemmas of scientific work today and a sign of the complexity of public policies.

Transforming Power Relationships: Leadership, Risk, and Hope. IHS Political Science Series No. 135, May 2013

Chronic communal conflicts resemble the prisoner’s dilemma. Both communities prefer peace to war. But neither trusts the other, viewing the other’s gain as its own loss, so potentially shared interests often go unrealized. Achieving positive-sum outcomes from apparently zero-sum struggles requires a kind of riskembracing leadership. To succeed leaders must: a) see power relations as potentially positive-sum; b) strengthen negotiating adversaries instead of weakening them; and c) demonstrate hope for a positive future and take great personal risks to achieve it. Such leadership is exemplified by Nelson Mandela and F.W. de Klerk in the South African democratic transition. To illuminate the strategic dilemmas Mandela and de Klerk faced, we examine the work of Robert Axelrod, Thomas Schelling, and Josep Colomer, who highlight important dimensions of the problem but underplay the role of risk-embracing leadership. Finally we discuss leadership successes and failures in the Northern Ireland settlement and the Israeli-Palestinian conflict.

EU Law, International Law and Economic Sanctions against Terrorism: The Judiciary in Distress? Research Papers in Law, 3/2008

From the Introduction. This article seeks to examine the relationship between European Union law, international law, and the protection of fundamental rights in the light of recent case law of the European Court of Justice (ECJ) and the Court of First Instance (CFI) relating to economic sanctions against individuals. On 3 September 2008, the ECJ delivered its long-awaited judgment in Kadi and Al Barakaat on appeal from the CFI.3 In its judgment under appeal,4 the CFI had held that the European Community (EC) is competent to adopt regulations imposing economic sanctions against private organisations in pursuance of UN Security Council (UNSC) Resolutions seeking to combat terrorism; that although the EC is not bound directly by the UN Charter, it is bound pursuant to the EC Treaty to respect international law and give effect to UNSC; and that the CFI has jurisdiction to examine the compatibility of EC regulations implementing UNSC resolutions with fundamental rights not as protected by the EC but as protected by jus cogens. On appeal, following the Opinion of Maduro AG, the ECJ rejected the CFI’s approach. It held that UNSC resolutions are binding only in international law. It subjected the contested regulations to full review under EC human rights standards and found them in breach of the right to a hearing, the right to judicial protection and the right to property. Kadi and Al Barakaat is the most important judgment ever delivered by the ECJ on the relationship between EC and international law and one of its most important judgments on fundamental rights. It is imbued by constitutional confidence, commitment to the rule of law but also some scepticism towards international law. In the meantime, the CFI has delivered a number of other judgments on anti-terrorist sanctions assessing the limits of the “emergency constitution” at European level. The purpose of this paper is to examine the above case law and explore the dilemmas and tensions facing the EU judiciary in seeking to define and protect the EU’s distinct constitutional space. It is divided as follows. It first looks at the judgment in Kadi. After a short presentation of the factual and legal background, it explores the question whether the EU has competence to adopt smart sanctions. It then examines whether the EU is bound by resolutions of the Security Council, whether the ECJ has jurisdiction to review Community measures implementing such resolutions and the applicable standard of judicial scrutiny. It analyses the contrasting views of the CFI, the Advocate General, and the ECJ taking account also of the case law of the European Court of Human Rights (ECtHR). Further, it explores the consequences of annulling the contested regulation. It then turns to discussing CFI case law in relation to sanctions lists drawn up not by the UN Security Council but by the EC. The paper concludes by welcoming the judgment of the ECJ. Whilst its reasoning on the issue of Community competence is questionable, once such competence is established, it is difficult to support the abrogation of Community standards for the protection of fundamental rights. Such standards should ensure procedural due process whilst recognising the importance of public security.

The European Central Bank in the age of banking union. Bruegel Policy Contribution 2013/13, 1 October 2013

During the crisis the European Central Bank’s roles have been greatly extended beyond its price stability mandate. In addition to the primary objective of price stability and the secondary objective of supporting EU economic policies, we identify ten new tasks related to monetary policy and financial stability. We argue that there are three main constraints on monetary policy: fiscal dominance, financial repercussions and regional divergences. By assessing the ECB’s tasks in light of these constraints, we highlight a number of synergies between these tasks and the ECB’s primary mandate of price stability. But we highlight major conflicts of interest related to the ECB’s participation in financial assistance programmes. We also underline that the ECB’s government bond purchasing programmes have introduced the concept of ‘monetary policy under conditionality’, which involves major dilemmas. A solution would be a major change towards a US-style system, in which state public debts are small, there are no federal bail-outs for states, the central bank does not purchase state debt and banks do not hold state debt. Such a change is unrealistic in the foreseeable future.

To Be or Not to Be a Normative Power: The EU’s Promotion of Human Rights and Democracy in Russia. Bruges Regional Integration & Global Governance Papers 2/2013

The ‘Normative Power Europe’ debate has been a leitmotif in the academic discourse for over a decade. Far from being obsolete, the topic is as relevant as when the term was first coined by Ian Manners in 2002.1 ‘To be or not to be a normative power’ is certainly one of the existential dilemmas in the foreign policy of the European Union. This paper, however, intends to move beyond the black-and-white debate on whether the European Union is a normative power and to make it more nuanced by examining the factors that make it such. Contrary to the conventional perception that the European Union is a necessarily ‘benign’ force in the world, it assumes that it has aspirations to be a viable international actor. Consequently, it pursues different types of foreign policy behaviour with a varying degree of normativity in them. The paper addresses the question of under what conditions the European Union is a ‘normative power’. The findings of the study demonstrate that the ‘normative power’ of the European Union is conditioned upon internal and external elements, engaged in a complex interaction with a decisive role played by the often neglected external elements.