Introdução: A estratégia de tratamento baseado em metas tem sido extensamente estudada em pacientes com AR inicial. No entanto, estudos sobre os benefícios de longo prazo do controle de atividade de doença em pacientes com AR estabelecida ainda são escassos. Objetivo: Avaliar a efetividade de longo prazo da estratégia de tratamento baseado em metas em pacientes com artrite reumatoide estabelecida na prática diária. Métodos: Pacientes com AR, previamente tratados de forma convencional, iniciaram estratégia de tratamento baseado em metas, sendo incluídos de março de 2005 a fevereiro de 2007 e acompanhados até dezembro de 2014. Os pacientes eram avaliados a cada 3 meses até remissão ou baixa atividade de doença serem alcançadas, e após a cada 6 meses. O tratamento seguiu um escalonamento de acordo com as recomendações vigentes. A atividade de doença foi mensurada através do DAS28 e do CDAI e a capacidade funcional, através do HAQ-DI. As informações foram extraídas pela revisão de formulários e de tabelas padronizadas. Variações na atividade de doença e na capacidade funcional foram comparadas pelo teste de Wilcoxon e Equações de Estimativas Generalizadas (GEE) A mortalidade foi avaliada através da curva de Kaplan-Meier. Resultados: Duzentos e vinte e nove pacientes foram incluídos, com duração média de doença 10,6±7,4 anos. Dentre os pacientes em moderada e alta atividade de doença no início da coorte, houve significativa redução do DAS28 (4,6±0,1 vs. 3,1±0,1; p<0,001) e do CDAI (21,2±1,0 vs. 7,9±0,7; p<0,001). Também houve redução do HAQ-DI (1,3±0,05 vs 1,0±0,1; p<0,001). A proporção de pacientes em remissão ou em baixa atividade de doença aumentou de 20% para 62% pelo DAS28. Com a estratégia de tratamento baseado em metas, houve um aumento na proporção de pacientes em uso de biológico para 30%. A taxa de mortalidade foi de 24,2 por 1000 pacientes-ano, discretamente superior à descrita na literatura. Conclusão: A estratégia de tratamento baseado em metas com objetivo de remissão e de baixa atividade de doença é efetivo em pacientes com AR estabelecida. / Introduction: Treating RA to a target has become a landmark strategy to be pursued in every patient. Nonetheless, few studies have addressed the true long-term impact of a T2T strategy in a real-world setting with established RA patients. Objective. To examine the long-term effectiveness of a treat-to-target (T2T) strategy in patients with established rheumatoid arthritis (RA) in daily practice. Methods. Patients with RA who were previously given the standard of care were started on a T2T strategy between March 2005 and February 2007 and followed through December 2014. Participants were seen every 3 months until remission/low disease activity was achieved and every 6 months thereafter. Treatment escalation followed a step-up strategy, according to national recommendations. Disease activity was measured by the DAS28 score and Clinical Disease Activity Index (CDAI), and physical function by the Health Assessment Questionnaire (HAQ). Data were extracted with standardized forms and a chart review. Changes in disease activity and physical function were compared using Wilcoxon’s test and generalized estimating equations. Mortality was analyzed using a Kaplan–Meier survival curve. Results. Two hundred and twenty-nine patients were included, with a mean (S.D.) disease duration of 10.6 (7.4) years. Significant reductions were observed in DAS28 (4.6±0.1 vs. 3.1±0.1; p<0.001), CDAI (21.2±1.0 vs. 7.9±0.7; p<0.001), and HAQ (1.3±0.05 vs 1.0±0.1; p<0.001) scores. The proportion of participants in remission/with low disease activity according to DAS28 increased from 20% to 62%. During implementation of the T2T strategy, a gradual increase in the proportion of participants using biologics was observed, to nearly 30%. The mortality rate was 24.2 per 1000 patient-years, slightly higher than that reported in other cohorts. Conclusion. A treat-to-target strategy aiming for remission or low disease activity is effective in patients with established RA.

Introdução: A estratégia de tratamento baseado em metas tem sido extensamente estudada em pacientes com AR inicial. No entanto, estudos sobre os benefícios de longo prazo do controle de atividade de doença em pacientes com AR estabelecida ainda são escassos. Objetivo: Avaliar a efetividade de longo prazo da estratégia de tratamento baseado em metas em pacientes com artrite reumatoide estabelecida na prática diária. Métodos: Pacientes com AR, previamente tratados de forma convencional, iniciaram estratégia de tratamento baseado em metas, sendo incluídos de março de 2005 a fevereiro de 2007 e acompanhados até dezembro de 2014. Os pacientes eram avaliados a cada 3 meses até remissão ou baixa atividade de doença serem alcançadas, e após a cada 6 meses. O tratamento seguiu um escalonamento de acordo com as recomendações vigentes. A atividade de doença foi mensurada através do DAS28 e do CDAI e a capacidade funcional, através do HAQ-DI. As informações foram extraídas pela revisão de formulários e de tabelas padronizadas. Variações na atividade de doença e na capacidade funcional foram comparadas pelo teste de Wilcoxon e Equações de Estimativas Generalizadas (GEE) A mortalidade foi avaliada através da curva de Kaplan-Meier. Resultados: Duzentos e vinte e nove pacientes foram incluídos, com duração média de doença 10,6±7,4 anos. Dentre os pacientes em moderada e alta atividade de doença no início da coorte, houve significativa redução do DAS28 (4,6±0,1 vs. 3,1±0,1; p<0,001) e do CDAI (21,2±1,0 vs. 7,9±0,7; p<0,001). Também houve redução do HAQ-DI (1,3±0,05 vs 1,0±0,1; p<0,001). A proporção de pacientes em remissão ou em baixa atividade de doença aumentou de 20% para 62% pelo DAS28. Com a estratégia de tratamento baseado em metas, houve um aumento na proporção de pacientes em uso de biológico para 30%. A taxa de mortalidade foi de 24,2 por 1000 pacientes-ano, discretamente superior à descrita na literatura. Conclusão: A estratégia de tratamento baseado em metas com objetivo de remissão e de baixa atividade de doença é efetivo em pacientes com AR estabelecida. / Introduction: Treating RA to a target has become a landmark strategy to be pursued in every patient. Nonetheless, few studies have addressed the true long-term impact of a T2T strategy in a real-world setting with established RA patients. Objective. To examine the long-term effectiveness of a treat-to-target (T2T) strategy in patients with established rheumatoid arthritis (RA) in daily practice. Methods. Patients with RA who were previously given the standard of care were started on a T2T strategy between March 2005 and February 2007 and followed through December 2014. Participants were seen every 3 months until remission/low disease activity was achieved and every 6 months thereafter. Treatment escalation followed a step-up strategy, according to national recommendations. Disease activity was measured by the DAS28 score and Clinical Disease Activity Index (CDAI), and physical function by the Health Assessment Questionnaire (HAQ). Data were extracted with standardized forms and a chart review. Changes in disease activity and physical function were compared using Wilcoxon’s test and generalized estimating equations. Mortality was analyzed using a Kaplan–Meier survival curve. Results. Two hundred and twenty-nine patients were included, with a mean (S.D.) disease duration of 10.6 (7.4) years. Significant reductions were observed in DAS28 (4.6±0.1 vs. 3.1±0.1; p<0.001), CDAI (21.2±1.0 vs. 7.9±0.7; p<0.001), and HAQ (1.3±0.05 vs 1.0±0.1; p<0.001) scores. The proportion of participants in remission/with low disease activity according to DAS28 increased from 20% to 62%. During implementation of the T2T strategy, a gradual increase in the proportion of participants using biologics was observed, to nearly 30%. The mortality rate was 24.2 per 1000 patient-years, slightly higher than that reported in other cohorts. Conclusion. A treat-to-target strategy aiming for remission or low disease activity is effective in patients with established RA.

Companies need to constantly innovate and improve in order to remain profitable and keep up with competition. But innovation can be costly and knowledge and new ideas hard to find. Therefore companies outsource innovation and do so increasingly even though it is difficult to successfully decide when and how. When should companies try to come up with new ideas themselves, and when should they give the job to outside experts? Does outsourcing of innovation work in established markets, new markets, for incremental or disruptive innovations, for product or process types of innovations? Research involving small companies and outsourcing of innovation has not been widely addressed in the literature, this thesis intend to give a better understanding of this area. After conducting a literature review we went looking for specific answers to the questions what effect does the business newness and size of a company have on the success of outsourcing and is there a difference in the outcome of outsourcing of innovation regarding the areas product, process, market and organization. A survey among decision makers and decision influencers showed: 1. Outsourcing of product and market innovation in new business compared to established business was considered equally successful. 2. Outsourcing of process and organisation innovation in new business was considered significantly less successful compared to established business. 3. The perceived benefit from outsourcing product innovation is higher than perceived benefit from outsourcing of processes, markets or organizations innovation. 4. Market leaders (including those who were runner up) believes that outsourcing of organization innovation in established business is more successful compared to none market leaders same goes for outsourcing of process innovation. This thesis tries to explain these and other findings concerning outsourcing of innovation.

En 1962, Gerhard Richter peint Tisch. Dans ce tableau, une table représentée en perspective est biffée par une violente gestualité. L’espace pictural s’érige entre l’illusion de profondeur et l’affirmation matérielle de la toile et de la peinture. Impulsée par une pratique personnelle, mise en regard avec le travail actuel de jeunes artistes héritiers des altérations fécondes de Richter, tels que Adrian Ghenie, Duncan Wylie ou Stephen Bush, Les dislocations de l’espace pictural se penche sur les relations dynamiques qui animent une figuration en tension entre l’image et le pictural. Taches, semis et coulures déstabilisent les assises iconiques tout en créant des mondes ambigus. L’espace pictural oscille entre dextérité et lâcher-prise. L’inachèvement et les réserves exposent au regard les vacillements de ses strates constitutives. / Gerhard Richter painted Tisch in 1962. In this painting, a table, which is represented in perspective, has been erased with a violent gestural brushstroke. The pictorial space stands between the illusion of depth and the emphasized materiality of the canvas and the painting. The dislocations of the pictorial space, fostered by Richter’s personal practice and supplemented with the work of current young artists, heirs to his productive alterations, such as Adrian Ghenie, Duncan Wylie or Stephen Bush, these dislocations show the dynamic relationships which animate a figuration in tension with the picture and the painting. Stains, patterns, and streaks destabilize established iconic values while creating ambiguous worlds. The pictorial space oscillates between dexterity and letting go. The incompleteness and the reserves display the wavering of its constitutive layers.

The present study aims to explore and delve into early childhood education teachers’ perception and interpretation of children’s agency and participation in the daily routines and planned activities in kindergartens in Finland. The daily established routines and planned activities take a significant amount of time in kindergarten. Therefore, it is essential to scrutinize how teachers engage children’s preferences, opinions, and participation in daily practice. The abovementioned rationale motivates the present qualitative research study. Semi-structured interviews were conducted with five early childhood teachers. Three of them work in international kindergartens and two of them in bilingual kindergartens (Finnish-English). The interview consisted of open-ended questions. They were structured to probe early childhood teachers’ experience in respect of the implementation of children’s agency and participation in the daily practices and the challenges that pedagogical personnel face.  The collected data from the semi-structured interview were analyzed through thematic analysis. On one hand, the results showed a none or limited amount of children’s agency and participation in the daily established routines, whereas the amount of agency and participation is increased regarding the planned activities. On the other hand, challenging parameters are the management of the kindergarten and the number of children in a group.

Even the best developed policies can and do fail, without attaining their desired outcomes. Many countries have developed small business policies directed at supporting and creating a favourable environment for cultivating small business and entrepreneurship. Policies specifically aimed at entrepreneurship are less prominent but also growing (Lundström & Stevenson, 2005:53; United Nations Conference on Trade and Development (UNCTAD), 2012:1). The existence of entrepreneurship policies in developing nations continues to be rare, despite the belief that entrepreneurship can spur economic growth and employment. The literature review introduced various important elements within the field of small business and entrepreneurship and, specifically, in the policy domain. The context of policy monitoring and evaluation was also addressed. Furthermore, the literature revealed clear differences between small business and entrepreneurial ventures which were not genuinely considered when small business support was initiated in South Africa with the introduction of the National Small Business Act (No. 102 of 1996) as amended. Only a small business was defined by the Department of Trade and Industry (dti) and not an entrepreneurial venture (dti, 2003:8). At present, both start-up and established businesses are operating in South Africa with the possibility of either growing into a small business or entrepreneurial venture. The main purpose of this study is to evaluate the national small business policy of South Africa and to determine its shortcomings. An entrepreneurship policy was identified as a possible alternative to address the gaps left by the small business policy. A content analysis of entrepreneurship and small business policies highlighted that the main differences between these two policies are the focus on individuals versus business ventures; pre-start-up versus post-start-up support; and a broad versus narrow definition of which institutional structures constitute the support environment. In this research, constructs drawn from the literature study were used to formulate the conceptual framework, research questions and hypotheses. Quantifiable data were obtained from three groups of respondents – namely, start-up business owners, established business owners and government officials involved in small business development and entrepreneurship. The sample consisted of 23 government officials and 340 start-up and established business owners from five metropolitan municipalities in the Gauteng, KwaZulu-Natal and Western Cape provinces of South Africa. The empirical research was undertaken between 01 November 2011 and 30 April 2012. The One-Way ANOVA Test, Kruskal-Wallis One-Way ANOVA Test, Friedman Two-Way ANOVA Test, Mann-Whitney U Test and Chi-square Test were executed to present the statistical significant differences between the three groups of respondents. The statistical tests were also executed to illustrate the statistical significant differences within the different groups as well as within different metropolitan municipalities in selected provinces. Pearson’s correlation coefficient was conducted to determine whether there was a significant relationship between the different small business policy evaluation factors and the needs factors of business owners. The findings of this empirical study prove that the small business policy does not address the needs of both start-up and established business owners which may support their development into small business and entrepreneurial ventures. Even though there is a mismatch between the supply and demand of support services, this study did not find evidence to support the need for an entrepreneurship policy in South Africa to supplement the existing small business policy. Businesses will continue to operate irrespective of an additional policy. The results of the study can be utilised by government to formulate and design adequate policies that focus on the specific needs of start-up and established business owners. The contribution of this study to the body of knowledge, and the possible limitations of the study, are discussed. Areas of future research are outlined and various recommendations are made to guide current and prospective small business and entrepreneurship policy makers regarding the choice of policy instruments, monitoring and evaluation. In conclusion, this study demonstrates the importance and value of policies to business owners and entrepreneurs that can effectively assist business venture survival, growth and success. / Thesis (DCom)--University of Pretoria, 2014. / tm2015 / Business Management / DCom / Unrestricted

Cognitive adaptability has been conceptualised as the ability to effectively and appropriately change decision policies (i.e. to learn) given feedback (inputs) from the environmental context in which cognitive processing is embedded. Based on a large sample of 2650 established entrepreneurs in South Africa, this study attempts to determine how entrepreneurs cognitively adapt to unpredictable entrepreneurial environments. Multidimensional constructs representing cognitive adaptability and the Big Five personality traits were operationalised and empirically investigated. It was hypothesised that the Big Five personality trait dimensions of openness to experience, conscientiousness, extraversion and agreeableness are positively related to the cognitive adaptability dimensions of goal orientation, metacognitive knowledge, metacognitive experience, and metacognitive choice and monitoring. Neuroticism was hypthesised to be negatively related to the cognitive adaptability dimensions of goal orientation, metacognitive knowledge, metacognitive experience, metacognitive choice and monitoring. Hypotheses were tested using structured equation modelling and correlational and regression analysis. Results provide support for subcomponents of the Big Five personality traits. Intellectual interest (openness to experience), goal striving (conscientiousness), activity (extraversion), prosocial orientation (agreeableness) were found to be positively related to cognitive adaptability. They were found to be negatively related to prior metacognitive knowledge. Self-reproach (neuroticism) was found to be negatively related to cognitive adaptability. It was found to be positively related to prior metacognitive knowledge. This research builds on and extends existing literature on cognitive adaptability in an entrepreneurial context by bringing together two streams of literature from psychology metacognition and personality traits. The implications of the process for dynamic, adaptable thinking are important in an emerging context such as that found in South Africa. The results of this study will inform the practice of policy makers who are trying to encourage start-up entrepreneurs to think about thinking in unpredictable entrepreneurial environments. In terms of methodology, the use of a sample of established entrepreneurs is desirable for this type of research since metacognition is better studied in entrepreneurs who are involved in a series of activities. / Thesis (PhD)--University of Pretoria, 2016. / Business Management / PhD / Unrestricted

Since 2015, Greece has been in an unprecedented position. The Syrian civil war triggered the movement of more than 850,000 arrivals into Greece during 2015 (UNHCR, 2015). Being geographically situated as the closest European country to the east of Syria, Greece had to deal with a large increase in the number of migrating peoples to the country and by proxy, the European Union. This research seeks to understand how power relations between the island’s local population and its asylum seeker population are represented through an analysis of the discourse produced by the local daily press. In particular, the research reviews the discourse surrounding the island’s main square occupation by asylum seekers in April 2018. The theory of the established and outsiders is the framework used for the analysis, while Critical Discourse Analysis and General Inductive Approach constitutes the methodological ground of the thesis. The analysis showcases that Lesvos’ local daily press reproduces a discourse in line with the established and outsiders theory, attributing the local population as being established and the asylum seekers as being outsiders.

Indiana University-Purdue University Indianapolis (IUPUI) / As multicultural families become more established in Korea, researchers have paid increasing attention to enhancing the families’ quality of life. The number of multicultural families was only 619 in 1990 but jumped to 750,000 as of 2013. It is projected that the multicultural families will be accounted for 5 % of the total population, which is the enormously conspicuous number given that Korean society had been a homogeneous society for a long time. While several Korean studies have examined acculturation process of immigrants, there is little understanding of multicultural families’ work and family life. The purpose of this study is to investigate migrant women’s later stage of adaptation by measuring their subjective perception of life satisfaction focusing on two key factors: migrant wives’ employment and perceived practical support from Korean husbands. Using data from the 2012 National Survey on Multicultural Families, a nationwide survey implemented in Korea, the hierarchical regression model of migrant wives’ life satisfaction was conducted with the following set of predictors: demographics, social-relationship factors, and employment and perceived practical support from Korean husbands in household labor and child-caring. Study results found that the higher levels of life satisfaction were observed among migrant wives who had higher levels of relationship satisfaction with Korean husbands (β = .414, p < .001), had more participation in community events and activities (β = .059, p < .001), and had more networks with people (β = .017, p < .001). Two main predictors also contributed to determine levels of life satisfaction. Employed migrant wives showed lower levels of life satisfaction than non-employed wives (β = -.083, p < .001). Migrant wives who had higher levels of perceived practical support from Korean husbands in child care showed higher levels of life satisfaction (β = .018, p < .001), but no impact was found in housework. For established multicultural families, findings highlight the importance of perceived practical support from Korean husbands particularly in childcare as a critical resource of support. Social work implications were discussed in order to improve established migrant wives’ life satisfaction and enhance their later stage of integration in Korean society.

The rise of the internet and the digital world becoming a bigger part of our lives has provided a new platform for adults to contact children for sexual purposes. The alternative media Dumpen.se has, with its controversial approach, taken responsibility for solving this problem and their work has been met with diligent reporting in established media. The purpose of the thesis is therefore to investigate how established media frame alternative media, with Dumpen as a case, in their articles. In addition, attitudes and possible power relations will be addressed. The study will answer the questions: (1) What main themes can be identified in the media reporting on Dumpen in Swedish established media? and (2) What attitudes and possible power relations are being portrayed? In order to answer this a thematic analysis has been executed on articles that deal with Dumpen during a selected time frame. The thesis uses framing theory as a theoretical framework. The results reveal that Dumpen is framed by established media through three distinctive main themes: Legal issues, Ethical issues and The role of media. The attitudes portrayed are generally negative towards Dumpen. The study has contributed to developing the research field by examining how established media choose to portray another smaller media, in the form of Dumpen.se, which is a new group that has received a lot of attention in society.