scholarly journals Till Time (and Poor Planning) Do Us Part: Programs as Dynamic Systems—Incorporating Planning of Sustainability into Theories of Change

2019 ◽  
Vol 33 (3) ◽  
Author(s):  
Sanjeev Sridharan ◽  
April Nakaima
Keyword(s):  
Dynamic Systems ◽  
Dynamic Process ◽  
Critical Aspect ◽  
Dynamic Complexity ◽  
Theories Of Change ◽  
Sustain Ability ◽  
The Impact ◽  
Over Time

This article describes the need for, and challenge of, representing the sustainability of a program as a dynamic process. Part of what enhances the complexity of programs is the challenge of dynamic complexity—the complexity of the program evolves over time through the interaction of actors and their environment. The problem is not just one of representation but also of planning—specifically planning for sustain-ability. We argue that an essential part of any accountability regime is planning for sustainability. Using the concept of programs as dynamic process, we argue that planning for sustainability needs to be a critical aspect of the impact chains of all theories of change. Both the representation and testing aspects of such a formulation are discussed.

The Therapist’s Reaction to a Patient’s Suicide

Crisis ◽  
2011 ◽  
Vol 32 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Friedrich Martin Wurst ◽  
Isabella Kunz ◽  
Gregory Skipper ◽  
Manfred Wolfersdorf ◽  
Karl H. Beine ◽  
...  
Keyword(s):  
Emotional Responses ◽  
Well Being ◽  
Emotional Reaction ◽  
Emotional Reactions ◽  
Analog Scale ◽  
General Hospitals ◽  
Item Questionnaire ◽  
Retrospective Nature ◽  
The Impact ◽  
Over Time

Background: A substantial proportion of therapists experience the loss of a patient to suicide at some point during their professional life. Aims: To assess (1) the impact of a patient’s suicide on therapists distress and well-being over time, (2) which factors contribute to the reaction, and (3) which subgroup might need special interventions in the aftermath of suicide. Methods: A 63-item questionnaire was sent to all 185 Psychiatric Clinics at General Hospitals in Germany. The emotional reaction of therapists to patient’s suicide was measured immediately, after 2 weeks, and after 6 months. Results: Three out of ten therapists suffer from severe distress after a patients’ suicide. The item “overall distress” immediately after the suicide predicts emotional reactions and changes in behavior. The emotional responses immediately after the suicide explained 43.5% of the variance of total distress in a regression analysis. Limitations: The retrospective nature of the study is its primary limitation. Conclusions: Our data suggest that identifying the severely distressed subgroup could be done using a visual analog scale for overall distress. As a consequence, more specific and intensified help could be provided to these professionals.

Has Aid Helped in Pakistan?

1997 ◽  
Vol 36 (4II) ◽  
pp. 947-957 ◽  
Author(s):  
Shahrukh Rafi Khan
Keyword(s):  
Economic Growth ◽  
Negative Impact ◽  
Negative Association ◽  
Causal Impact ◽  
The Impact ◽  
Over Time

This paper has a two-fold objective: first, to examine the terms on which Pakistan receives aid and whether its debt situation is sustainable, and second, to examine the impact of aid and debt on economic growth. It is found that there is little encouraging that can be said about how the terms on which Pakistan has received aid over time have changed, and its current debt situation is not sustainable. Also reported is the analysis done elsewhere which shows that aid has a negative (Granger) causal impact on GDP, and aid has a robust negative impact on economic growth after controlling for supplyside shocks. We provide various reasons for this negative association.

The Role of Vascular Aging in Atherosclerotic Plaque Development and Vulnerability

2019 ◽  
Vol 25 (29) ◽  
pp. 3098-3111 ◽  
Author(s):  
Luca Liberale ◽  
Giovanni G. Camici
Keyword(s):  
Atherosclerotic Plaque ◽  
Molecular Mechanisms ◽  
Driving Forces ◽  
Plaque Burden ◽  
Vascular Aging ◽  
Age Related ◽  
Plaque Development ◽  
Increased Risk ◽  
The Impact ◽  
Over Time

Background: The ongoing demographical shift is leading to an unprecedented aging of the population. As a consequence, the prevalence of age-related diseases, such as atherosclerosis and its thrombotic complications is set to increase in the near future. Endothelial dysfunction and vascular stiffening characterize arterial aging and set the stage for the development of cardiovascular diseases. Atherosclerotic plaques evolve over time, the extent to which these changes might affect their stability and predispose to sudden complications remains to be determined. Recent advances in imaging technology will allow for longitudinal prospective studies following the progression of plaque burden aimed at better characterizing changes over time associated with plaque stability or rupture. Oxidative stress and inflammation, firmly established driving forces of age-related CV dysfunction, also play an important role in atherosclerotic plaque destabilization and rupture. Several genes involved in lifespan determination are known regulator of redox cellular balance and pre-clinical evidence underlines their pathophysiological roles in age-related cardiovascular dysfunction and atherosclerosis. Objective: The aim of this narrative review is to examine the impact of aging on arterial function and atherosclerotic plaque development. Furthermore, we report how molecular mechanisms of vascular aging might regulate age-related plaque modifications and how this may help to identify novel therapeutic targets to attenuate the increased risk of CV disease in elderly people.

Conclusion

2018 ◽  
Author(s):  
Manuel Fröhlich ◽  
Abiodun Williams
Keyword(s):  
Security Council ◽  
International Context ◽  
Peace And Security ◽  
Executive Action ◽  
Trends Over Time ◽  
The Impact ◽  
Over Time ◽  
The Way ◽  
Guiding Questions

The Conclusion returns to the guiding questions introduced in the Introduction, looking at the way in which the book’s chapters answered them. As such, it identifies recurring themes, experiences, structures, motives, and trends over time. By summarizing the result of the chapters’ research into the interaction between the Secretaries-General and the Security Council, some lessons are identified on the changing calculus of appointments, the conditions and relevance of the international context, the impact of different personalities in that interaction, the changes in agenda and composition of the Council as well as different formats of interaction and different challenges to be met in the realm of peace and security, administration, and reform, as well as concepts and norms. Taken together, they also illustrate the potential and limitations of UN executive action.

Understanding Rising Income Inequality and Stagnating Ordinary Living Standards in Germany

2018 ◽  
Author(s):  
Gerhard Bosch ◽  
Thorsten Kalina
Keyword(s):  
Income Inequality ◽  
Labour Market ◽  
Economic Crisis ◽  
Household Income ◽  
Wage Bargaining ◽  
Living Standards ◽  
Social Model ◽  
Real Wages ◽  
The Impact ◽  
Over Time

This chapter describes how inequality and real incomes have evolved in Germany through the period from the 1980s, through reunification, up to the economic Crisis and its aftermath. It brings out how reunification was associated with a prolonged stagnation in real wages. It emphasizes how the distinctive German structures for wage bargaining were eroded over time, and the labour market and tax/transfer reforms of the late 1990s-early/mid-2000s led to increasing dualization in the labour market. The consequence was a marked increase in household income inequality, which went together with wage stagnation for much of the 1990s and subsequently. Coordination between government, employers, and unions still sufficed to avoid the impact the economic Crisis had on unemployment elsewhere, but the German social model has been altered fundamentally over the period

Dualities, Dialectics, and Paradoxes in Organizational Life

2018 ◽  
Keyword(s):  
Dynamic Systems ◽  
Empirical Studies ◽  
Organizational Studies ◽  
Organizational Life ◽  
Organizational Processes ◽  
Organization Studies ◽  
Process Studies ◽  
Convergence And Divergence ◽  
Insight Into ◽  
Over Time

Organizational contradictions and process studies offer interwoven and complementary insights. Studies of dialectics, paradox, and dualities depict organizational contradictions that are oppositional as well as interrelated such that they persistently morph and shift over time. Studies of process often examine how contradictions fuel emergent, dynamic systems and stimulate novelty, adaptation, and transformation. Drawing from rich conversations at the Eighth International Symposium on Process Organization Studies, the contributors to this volume unpack these relationships in more depth. The chapters explore three main, connected themes through both conceptual and empirical studies, including (1) offering insight into how process theorizing advances understandings of organizational contradictions; (2) shedding light on how dialectics, paradoxes, and dualities fuel organizational processes that affect persistence and transformation; and (3) exploring the convergence and divergence of dialectics, paradox, and dualities lenses. Taken together, this book offers key insights in order to inform persistent, contradictory dynamics in organizations and organizational studies.

A Melanocortin-4 Receptor Agonist Induces Skin and Hair Pigmentation in Patients with Monogenic Mutations in the Leptin-Melanocortin Pathway

2021 ◽  
pp. 1-10
Author(s):  
Varvara Kanti ◽  
Lia Puder ◽  
Irina Jahnke ◽  
Philipp Maximilian Krabusch ◽  
Jan Kottner ◽  
...  
Keyword(s):  
Leptin Receptor ◽  
Skin Pigmentation ◽  
Gene Mutations ◽  
Continuous Treatment ◽  
Whole Body ◽  
Hair Color ◽  
Phase 2 ◽  
Loss Of Function ◽  
The Impact ◽  
Over Time

<b><i>Background and Objectives:</i></b> Gene mutations within the leptin-melanocortin signaling pathway lead to severe early-onset obesity. Recently, a phase 2 trial evaluated new pharmacological treatment options with the MC4R agonist <i>setmelanotide</i> in patients with mutations in the genes encoding proopiomelanocortin (POMC) and leptin receptor (LEPR). During treatment with <i>setmelanotide,</i> changes in skin pigmentation were observed, probably due to off-target effects on the closely related melanocortin 1 receptor (MC1R). Here, we describe in detail the findings of dermatological examinations and measurements of skin pigmentation during this treatment over time and discuss the impact of these changes on patient safety. <b><i>Methods:</i></b> In an investigator-initiated, phase 2, open-label pilot study, 2 patients with loss-of-function POMC gene mutations and 3 patients with loss-of-function variants in LEPR were treated with the MC4R agonist <i>setmelanotide</i>. Dermatological examination, dermoscopy, whole body photographic documentation, and spectrophotometric measurements were performed at screening visit and approximately every 3 months during the course of the study. <b><i>Results:</i></b> We report the results of a maximum treatment duration of 46 months. Skin pigmentation increased in all treated patients, as confirmed by spectrophotometry. During continuous treatment, the current results indicate that elevated tanning intensity levels may stabilize over time. Lips and nevi also darkened. In red-haired study participants, hair color changed to brown after initiation of <i>setmelanotide</i> treatment. <b><i>Discussion:</i></b> <i>Setmelanotide</i> treatment leads to skin tanning and occasionally hair color darkening in both POMC- and LEPR-deficient patients. No malignant skin changes were observed in the patients of this study. However, the results highlight the importance of regular skin examinations before and during MC4R agonist treatment.

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