985 resultados para Demographic change


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The 2015 edition of Social Panorama of Latin America analyses poverty trends, as measured by ECLAC. It also examines changes in income distribution and in other aspects of inequality. With a view to contributing to the development of public policies to overcome poverty and socioeconomic inequality, this edition examines the latest trends in social spending and the challenges posed by demographic change, and provides in-depth analysis of persistent gaps in the labour market, of the challenges facing policies and programmes that foster inclusion in the labour market and production, and of social development institutions in Latin America.

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The latter part of the 20th century was a period characterized by a fundamental demographic transition of western society. This substantial and structural demographic change proposes several challenges to contemporary society and fosters the emergence of new issues and challenges. Among these, none is more crucial than the comprehension of the mechanisms and the processes that lead people to positive aging. Rowe and Kahn’s model of successful aging highlights the interplay between social engagement with life, health, and functioning for a positive aging experience. Other systemic models of successful aging (Kahana et al., 1996; 2003; Stevernik et al., 2006) emphasize the role of internal and external resources for attaining positive aging. Among these, the proactive coping strategies are indicated as important active strategies for avoiding the depletion of resources, counterbalancing the declines and maintaining social and civic involvement. The study has analyzed the role of proactive coping strategies for two facets of positive aging, the experience of a high social well-being and the presence of personal projects in fundamental life domains. As expected, the proactive coping strategies, referred to as the active management of the environment, the accumulation of resources and the actualization of human potentials are confirmed as positive predictors of high level of social well-being and of many personal projects focused on family, culture, leisure time, civic and social participation. Perceived health status give a significant contribution only to the possession of many personal projects. Gender and level of school education give also a significant contribution to these two dimensions of positive aging, highlighting how positive aging is rooted not only in the possession of personal resources, but also in historical models of education and in positive longitudinal chains related to early development.

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This thesis assesses the question, whether accounting for non-tradable goods sectors in a calibrated Auerbach-Kotlikoff multi-regional overlapping-generations-model significantly affects this model’s results when simulating the economic impact of demographic change. Non-tradable goods constitute a major part of up to 80 percent of GDP of modern economies. At the same time, multi-regional overlapping-generations-models presented by literature on demographic change so far ignored their existence and counterfactually assumed perfect tradability between model regions. Moreover, this thesis introduces the assumption of an increasing preference share for non-tradable goods of old generations. This fact-based as-sumption is also not part of models in relevant literature. rnThese obvious simplifications of common models vis-à-vis reality notwithstanding, this thesis concludes that differences in results between a model featuring non-tradable goods and a common model with perfect tradability are very small. In other words, the common simplifi-cation of ignoring non-tradable goods is unlikely to lead to significant distortions in model results. rnIn order to ensure that differences in results between the ‘new’ model, featuring both non-tradable and tradable goods, and the common model solely reflect deviations due to the more realistic structure of the ‘new’ model, both models are calibrated to match exactly the same benchmark data and thus do not show deviations in their respective baseline steady states.rnA variation analysis performed in this thesis suggests that differences between the common model and a model with non-tradable goods can theoretically be large, but only if the bench-mark tradable goods sector is assumed to be unrealistically small.rnFinally, this thesis analyzes potential real exchange rate effects of demographic change, which could occur due to regional price differences of non-tradable goods. However, results show that shifts in real exchange rate based on these price differences are negligible.rn

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Background: The CAMbrella coordination action was funded within the Framework Programme 7. Its aim is to provide a research roadmap for clinical and epidemiological research for complementary and alternative medicine (CAM) that is appropriate for the health needs of European citizens and acceptable to their national research institutes and healthcare providers in both public and private sectors. One major issue in the European research agenda is the demographic change and its impact on health care. Our vision for 2020 is that there is an evidence base that enables European citizens to make informed decisions about CAM, both positive and negative. This roadmap proposes a strategic research agenda for the field of CAM designed to address future European health care challenges. This roadmap is based on the results of CAMbrella’s several work packages, literature reviews and expert discussions including a consensus meeting. Methods: We first conducted a systematic literature review on key issues in clinical and epidemiological research in CAM to identify the general concepts, methods and the strengths and weaknesses of current CAM research. These findings were discussed in a workshop (Castellaro, Italy, September 7–9th 2011) with international CAM experts and strategic and methodological recommendations were defined in order to improve the rigor and relevance of CAM research. These recommendations provide the basis for the research roadmap, which was subsequently discussed in a consensus conference (Järna, Sweden, May 9–11th 2012) with all CAMbrella members and the CAMbrella advisory board. The roadmap was revised after this discussion in CAMbrella Work Package (WP) 7 and finally approved by CAMbrella’s scientific steering committee on September 26th 2012. Results: Our main findings show that CAM is very heterogenous in terms of definitions and legal regulations between the European countries. In addition, citizens’ needs and attitudes towards CAM as well as the use and provision of CAM differ significantly between countries. In terms of research methodology, there was consensus that CAM researchers should make use of all the commonly accepted scientific research methods and employ those with utmost diligence combined in a mixed methods framework. Conclusions: We propose 6 core areas of research that should be investigated to achieve a robust knowledge base and to allow stakeholders to make informed decisions. These are: Research into the prevalence of CAM in Europe: Reviews show that we do not know enough about the circumstances in which CAM is used by Europeans. To enable a common European strategic approach, a clear picture of current use is of the utmost importance. Research into differences regarding citizens’ attitudes and needs towards CAM: Citizens are the driver for CAM utilization. Their needs and views on CAM are a key priority, and their interests must be investigated and addressed in future CAM research. Research into safety of CAM: Safety is a key issue for European citizens. CAM is considered safe, but reliable data is scarce although urgently needed in order to assess the risk and cost-benefit ratio of CAM. Research into the comparative effectiveness of CAM: Everybody needs to know in what situation CAM is a reasonable choice. Therefore, we recommend a clear emphasis on concurrent evaluation of the overall effectiveness of CAM as an additional or alternative treatment strategy in real-world settings. Research into effects of context and meaning: The impact of effects of context and meaning on the outcome of CAM treatments must be investigated; it is likely that they are significant. Research into different models of CAM health care integration: There are different models of CAM being integrated into conventional medicine throughout Europe, each with their respective strengths and limitations. These models should be described and concurrently evaluated; innovative models of CAM provision in health care systems should be one focus for CAM research. We also propose a methodological framework for CAM research. We consider that a framework of mixed methodological approaches is likely to yield the most useful information. In this model, all available research strategies including comparative effectiveness research utilising quantitative and qualitative methods should be considered to enable us to secure the greatest density of knowledge possible. Stakeholders, such as citizens, patients and providers, should be involved in every stage of developing the specific and relevant research questions, study design and the assurance of real-world relevance for the research. Furthermore, structural and sufficient financial support for research into CAM is needed to strengthen CAM research capacity if we wish to understand why it remains so popular within the EU. In order to consider employing CAM as part of the solution to the health care, health creation and self-care challenges we face by 2020, it is vital to obtain a robust picture of CAM use and reliable information about its cost, safety and effectiveness in real-world settings. We need to consider the availability, accessibility and affordability of CAM. We need to engage in research excellence and utilise comparative effectiveness approaches and mixed methods to obtain this data. Our recommendations are both strategic and methodological. They are presented for the consideration of researchers and funders while being designed to answer the important and implicit questions posed by EU citizens currently using CAM in apparently increasing numbers. We propose that the EU actively supports an EUwide strategic approach that facilitates the development of CAM research. This could be achieved in the first instance through funding a European CAM coordinating research office dedicated to foster systematic communication between EU governments, public, charitable and industry funders as well as researchers, citizens and other stakeholders. The aim of this office would be to coordinate research strategy developments and research funding opportunities, as well as to document and disseminate international research activities in this field. With the aim to develop sustainability as second step, a European Centre for CAM should be established that takes over the monitoring and further development of a coordinated research strategy for CAM, as well as it should have funds that can be awarded to foster high quality and robust independent research with a focus on citizens health needs and pan-European collaboration. We wish to establish a solid funding for CAM research to adequately inform health care and health creation decision-making throughout the EU. This centre would ensure that our vision of a common, strategic and scientifically rigorous approach to CAM research becomes our legacy and Europe’s reality. We are confident that our recommendations will serve these essential goals for EU citizens.

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We review alternative hypotheses and associated mechanisms to explain Lake Victoria’s Nile perch takeover and concurrent reduction in haplochromines through a (re)analysis of long term climate, limnological and stock observations in comparison with size-spectrum model predictions of co-existence, extinction and demographic change. The empirical observations are in agreement with the outcomes of the model containing two interacting species with life-histories matching Nile perch and a generalized haplochromine. The dynamic interactions may have depended on size related differences in early juvenile mortality: mouth-brooding haplochromines escape predation mortality in early life stages, unlike Nile perch that have miniscule planktonic eggs and larvae. In our model predation on the latter by planktivorous haplochromine fry act as a stabilizing factor for co-existence, but external mortality on the haplochromines would disrupt this balance in favor of Nile perch. To explain the observed switch, mortality on haplochromines would need to be much higher than the fishing mortality that can be realistically re-constructed from observations. Abrupt concomitant changes in algal and zooplankton composition, decreased water column transparency, and widespread hypoxia from increased eutrophication most likely caused haplochromine biomass decline. We hypothesize that the shift to Nile perch was a consequence of an externally caused, climate triggered, decrease in haplochromine biomass and associated recruitment failure rather than a direct cause of the introduction.

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The sustainable development paradigm raises issues of global, intra- and intergenerational social equity as well as respect for nature, and economic welfare. Switzerland is confronted by these issues within its own country, and has a moral responsibility vis-a-vis the rest of the world. Syndromes of global change are affecting many eco-regions, not only in developing and transition countries, but to a lesser extent also the affluent countries. Switzerland as a nation has an impact on syndromes through its far-reaching economic activities, which are non-sustainable. At the global level, more modest consumption patterns, a considerably slowed demographic change, a nonconsumptive but sustainable use of natural resources, and conflict transformation are the main prerequisites for improving sustainability. Switzerland's current contribution to sustainability is much less than what it could be, hence the need for additional action along general principles in,accordance with Swiss traditions and innovative potentials. A number of concrete actions could be taken immediately. These are: labelling the socially and ecologically sustainable production of goods and services, and their negotiation at WTO level; enhancing international cooperation and research; strengthening education and research for sustainability, and emphasizing energy and material flux efficiency at home and abroad.

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The preservation of tangible cultural heritage does not guarantee effective revitalisation of urban historic areas as a whole. The legacy of our history consists not only of paintings, sculptures, architectural monuments and public spaces, but also the safeguarding of immaterial aspects of social life, such as oral traditions, rituals, practices, knowledge and craft skills. From 1999 to 2013, 26 Brazilian cities benefited from the Monumenta Programme - a national cultural policy that involved institutions, the private sector and the local community. The purpose of the programme was to stimulate economic growth and increase cultural and social development of the historic centres. Moreover, it sought to increase the number of residents in the benefited areas as defined in its agenda (IDB, 1999; MinC & Programa Monumenta, 2006). Using the Historic Centre of Porto Alegre as a case study, this paper examines how this cultural programme enables demographic change through the promotion of intangible cultural heritage, e.g. by supporting educational projects. The demographic flow was analysed using the microdata of the Populations Censuses (years 2000 and 2010) available from the Brazilian Institute of Geography and Statistics. The results showed an increase in low-income residents the areas that participated in the programme. This increase may have been motivated by a set of cultural-educational projects under the auspices of the Monumenta Programme. The retraining of artisans of Alfândega Square, the training of low-income youth for restoration work and the implementation of the "Black Route Museum in Porto Alegre" (Bicca, 2010) are just some examples of what was done to improve the local community's economy, to encourage social cohesion and to enhance the awareness of cultural diversity as a positive and essential value in society.

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O presente trabalho versa sobre a relação presente e futura dos planos de saúde com os idosos. Tem como pressupostos iniciais a existência de uma janela demográfica de oportunidades que será encerrada, conforme estimativa do IBGE, em 2020 e o fato de o modelo de atenção à saúde por planos de saúde se encontrar em expansão. Diante da realidade de envelhecimento populacional, pergunta-se: Os planos de saúde são um modelo viável para a garantia da atenção à saúde dos idosos? As respostas a essa questão foram construídas adotando-se como método de trabalho a análise de doutrina, jurisprudência, legislação e, quando necessário, fontes não tradicionais do Direito como os dados de órgãos de pesquisa demográficos e econômicos, a imprensa e as associações setoriais. Inicialmente tratou-se do funcionamento do setor de planos de saúde, desde a sua origem, indicando-se que historicamente sempre manteve uma relação simbiótica com o Estado, em especial com os recursos públicos. Para tanto, foram explorados temas como o ressarcimento ao SUS, o uso da estrutura dos hospitais públicos pelos planos de saúde e a existência de subsídios, abatimentos e outras formas de financiamento público das atividades deste setor. No capítulo seguinte se detalhou a questão do envelhecimento populacional, apresentando-se a legislação pertinente, os dados que revelam a composição presente e estimada da população brasileira, os principais problemas de saúde que afetam os idosos e os impactos da mudança de perfil demográfico para a política de saúde. No capítulo 3 evidenciou-se a já problemática relação dos planos de saúde com os idosos, permeada por discriminações na contratação, cobrança de mensalidades proibitivas e reajustes expulsivos, presença de cláusulas abusivas em contratos antigos, judicialização dos reajustes por mudança de faixa etária e conflitos decorrentes da prevalência da contratação na forma coletiva. Por fim, no derradeiro capítulo concluiu-se que o modelo de planos de saúde não é viável para a garantia da atenção à saúde do idoso, sendo urgente que haja uma discussão sobre qual modelo de saúde o país deseja sob pena de que as conquistas decorrentes da afirmação da saúde como direito fundamental se percam. Há características inerentes ao setor que o aparta dos idosos e, portanto, da nova realidade demográfica do país, como a prática da seleção de risco, a cobrança de mensalidades com preços insustentáveis para os idosos, o foco no modelo curativo de atenção à saúde e o afastamento da prevenção. Por outro lado, o cenário se agrava por conta das recorrentes falhas na regulação e na regulamentação, e pelo tratamento cindido, na prática, da política de saúde como se não fosse una e não devesse funcionar em harmonia, independentemente da fonte de financiamento. Há, portanto, um alto risco de que a situação dos idosos nos planos de saúde se torne insustentável, dando margem a medidas imediatistas ampliadoras dos subsídios públicos aos planos de saúde. A contrarreforma sanitária, entendida como o retrocesso das ações e dos serviços de saúde ao modelo anterior à Constituição Federal, é um perigo a ser considerado e combatido.

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A alteração demográfica característica deste século e a desertificação do interior, em detrimento de grandes meios urbanos, no litoral, tem levado a que a população seja maioritariamente idosa e isolada. A falta de perspectiva, valorização pessoal e mesmo objectivos de vida conduzem à solidão, constituindo-se um dos principais problemas dos dias de hoje, com repercussões a nível social e económico. Este trabalho surge exactamente nesse sentido, constituindo-se numa forma de modificar atitudes e comportamentos dos idosos, tornando-os, dentro das limitações e gostos individuais, mais ativos e, tendencialmente, menos sedentários. Com o tema: A percepção sobre a solidão e qualidade de vida no envelhecimento: impacto de um projeto de animação sociocultural, tem como objectivo conhecer o impacto de um plano de actividades de animação sociocultural, na perceção sobre a solidão e qualidade de vida de vida de um grupo de pessoas com mais 65 anos. O trabalho apresentado está estruturado em três partes: enquadramento conceptual, metodologia e apresentação e discussão dos resultados, onde se identificam os dados da solidão como barreira limitativa e as condicionantes que provoca aos diferentes níveis na qualidade de vida do indivíduo. Através de uma série de atividades de animação sociocultural, com carácter lúdico e informal, propõe-se despertar os idosos para as vantagens de uma socialização mais ativa, como forma de estímulo também a nível cognitivo. Relativamente à metodologia do trabalho, optou-se por uma recolha de dados fidedigna através da versão portuguesa da Escala de Solidão da UCLA e pela versão portuguesa do WHOQOL-100 sendo o trabalho centrado no estudo da evolução destas variáveis nos idosos, antes e depois das actividades. O grupo estudado é constituído por catorze reformados, residentes no concelho de Portalegre, com idades compreendidas entre os 63 e os 83 anos, de ambos os géneros, e com escolaridade que varia entre a 4ª ano do ensino básico e o ensino superior, permitindo uma abordagem abrangente. Relativamente aos domínios da qualidade de vida foram encontrados valores superiores em todos os domínios, na avaliação efectuada após as atividades, sendo essas diferenças estatisticamente significativas em todos os domínios excepto no Domínio Psicológico. Na variável solidão foram encontrados valores superiores de percepção da solidão após a realização das atividades embora essa diferença não seja estatisticamente significativa. Relativamente aos resultados informais, percebeu-se que todo o grupo mostrou interesse em participar nas atividades de carácter cultural e social propostas, referindo nos seus próprios depoimentos a vontade de continuar, reconhecendo as diferenças no seu próprio comportamento e as significativas melhorias nas suas vivências e de relação com o outro, atribuindo outra visão ao seu tempo livre e participação ativa num envelhecimento que reconheceram como “mais saudável”.

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The frequency of extreme environmental events is predicted to increase in the future. Understanding the short- and long-term impacts of these extreme events on large-bodied predators will provide insight into the spatial and temporal scales at which acute environmental disturbances in top-down processes may persist within and across ecosystems. Here, we use long-term studies of movements and age structure of an estuarine top predator—juvenile bull sharks Carcharhinus leucas—to identify the effects of an extreme ‘cold snap’ from 2 to 13 January 2010 over short (weeks) to intermediate (months) time scales. Juvenile bull sharks are typically year-round residents of the Shark River Estuary until they reach 3 to 5 yr of age. However, acoustic telemetry revealed that almost all sharks either permanently left the system or died during the cold snap. For 116 d after the cold snap, no sharks were detected in the system with telemetry or captured during longline sampling. Once sharks returned, both the size structure and abundance of the individuals present in the nursery had changed considerably. During 2010, individual longlines were 70% less likely to capture any sharks, and catch rates on successful longlines were 40% lower than during 2006−2009. Also, all sharks caught after the cold snap were young-of-the-year or neonates, suggesting that the majority of sharks in the estuary were new recruits and several cohorts had been largely lost from the nursery. The longer-term impacts of this change in bull shark abundance to the trophic dynamics of the estuary and the importance of episodic disturbances to bull shark population dynamics will require continued monitoring, but are of considerable interest because of the ecological roles of bull sharks within coastal estuaries and oceans.

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\abstract

This dissertation seeks to explain the role of governmental and non-governmental actors in increasing/reducing the emergence of intergroup conflict after war, when group differences have been a salient aspect of group mobilization. This question emerges from several interrelated branches of scholarship on self-enforcing institutions and power-sharing arrangements, group fragmentation and demographic change, collective mobilization for collectively-targeted violence, and conflict termination and the post-conflict quality of peace. This question is investigated through quantitative analyses performed at the sub-national, national, and cross-national level on the effect of elite competition on the likelihood of violence committed on the basis of group difference after war. These quantitative analyses are each accompanied by qualitative, case study analyses drawn from the American Reconstruction South, Iraq, and Cote d'Ivoire that illustrate and clarify the mechanisms evaluated through quantitative analysis.

Shared findings suggest the correlation of reduced political competition with the increased likelihood of violence committed on the basis of group difference. Separate findings shed light on how covariates related to control over rent extraction and armed forces, decentralization, and citizenship can lead to a reduction in violence. However, these same quantitative analyses and case study analysis suggest that the control of the state can be perceived as a threat after the end of conflict. Further, together these findings suggest the political nature of violence committed on the basis of group difference as opposed to ethnic identity or resource scarcity alone.

Together, these combined analyses shed light on how and why political identities are formed and mobilized for the purpose of committing political violence after war. In this sense, they shed light on the factors that constrain post-conflict violence in deeply divided societies, and contribute to relevant academic, policy, and normative questions.

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Widespread flooding in June 2013 caused damage costs of €6 to 8 billion in Germany, and awoke many memories of the floods in August 2002, which resulted in total damage of €11.6 billion and hence was the most expensive natural hazard event in Germany up to now. The event of 2002 does, however, also mark a reorientation toward an integrated flood risk management system in Germany. Therefore, the flood of 2013 offered the opportunity to review how the measures that politics, administration, and civil society have implemented since 2002 helped to cope with the flood and what still needs to be done to achieve effective and more integrated flood risk management. The review highlights considerable improvements on many levels, in particular (1) an increased consideration of flood hazards in spatial planning and urban development, (2) comprehensive property-level mitigation and preparedness measures, (3) more effective flood warnings and improved coordination of disaster response, and (4) a more targeted maintenance of flood defense systems. In 2013, this led to more effective flood management and to a reduction of damage. Nevertheless, important aspects remain unclear and need to be clarified. This particularly holds for balanced and coordinated strategies for reducing and overcoming the impacts of flooding in large catchments, cross-border and interdisciplinary cooperation, the role of the general public in the different phases of flood risk management, as well as a transparent risk transfer system. Recurring flood events reveal that flood risk management is a continuous task. Hence, risk drivers, such as climate change, land-use changes, economic developments, or demographic change and the resultant risks must be investigated at regular intervals, and risk reduction strategies and processes must be reassessed as well as adapted and implemented in a dialogue with all stakeholders.

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The elderly constitute a growing world population group, with more than 200 million people over 60 years of age. This fact has increased the detection of chronic-degenerative diseases, as well as the prescription and consumption of medicines. The elderly are particularly susceptible to adverse drug events or interactions with other drugs due to their physiological changes, genetic predisposition and environmental exposure. It becomes necessary to adapt the health systems with integral and multidisciplinary approaches suitable to this demographic change, as the knowledge about appropriate prescription, clinical pharmacology and medication use in the elderly has become essential. It has been shown that about two thirds of elderly patients receive inappropriate drug doses, and a substantial percentage of their hospital admissions are associated with potentially preventable toxic effects of drugs. To date, expert criteria, error detection tools and educational prescription plans have been developed by expert consensus for the safe use of drugs in the geriatric population. The objective of this study is a brief review of the principal physiological changes in an older adult, and summarize the contributions of the consensuses on prescription.

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Differential rates of demographic change between the developed and developing nations contribute to disparate living arrangements and contrasting cultural understandings of living together and alone. Among some cohorts in the developed world, who can afford it, living alone is seen as a lifestyle choice and representative of independence, thus not compromising of wellbeing. In some contexts living arrangements have minimal impact on wellbeing. However, in parts of the developing world, and among other cohorts in developed countries, living alone represents despair, abandonment and loneliness leading to diminished wellbeing. Overriding this cultural difference is the unambiguous population level data from across the world showing that intimate partnerships, particularly marriage, provide a protective shield against low personal wellbeing scores. The jury is still out on whether this protective effect necessarily involves cohabitation. The current rise in living- apart-together relationships and the possible future trend of living together virtually, through second life and other digital media, raises further questions about the nexus between living arrangements and wellbeing.

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The literature clearly links the quality and capacity of a country’s infrastructure to its economic growth and competitiveness. This thesis analyses the historic national and spatial distribution of investment by the Irish state in its physical networks (water, wastewater and roads) across the 34 local authorities and examines how Ireland is perceived internationally relative to its economic counterparts. An appraisal of the current status and shortcomings of Ireland’s infrastructure is undertaken using key stakeholders from foreign direct investment companies and national policymakers to identify Ireland's infrastructural gaps, along with current challenges in how the country is delivering infrastructure. The output of these interviews identified many issues with how infrastructure decision-making is currently undertaken. This led to an evaluation of how other countries are informing decision-making, and thus this thesis presents a framework of how and why Ireland should embrace a Systems of Systems (SoS) methodology approach to infrastructure decision-making going forward. In undertaking this study a number of other infrastructure challenges were identified: significant political interference in infrastructure decision-making and delivery the need for a national agency to remove the existing ‘silo’ type of mentality to infrastructure delivery how tax incentives can interfere with the market; and their significance. The two key infrastructure gaps identified during the interview process were: the need for government intervention in the rollout of sufficient communication capacity and at a competitive cost outside of Dublin; and the urgent need to address water quality and capacity with approximately 25% of the population currently being served by water of unacceptable quality. Despite considerable investment in its national infrastructure, Ireland’s infrastructure performance continues to trail behind its economic partners in the Eurozone and OECD. Ireland is projected to have the highest growth rate in the euro zone region in 2015 and 2016, albeit that it required a bailout in 2010, and, at the time of writing, is beginning to invest in its infrastructure networks again. This thesis proposes the development and implementation of a SoS approach for infrastructure decision-making which would be based on: existing spatial and capacity data of each of the constituent infrastructure networks; and scenario computation and analysis of alternative drivers eg. Demographic change, economic variability and demand/capacity constraints. The output from such an analysis would provide valuable evidence upon which policy makers and decision makers alike could rely, which has been lacking in historic investment decisions.