The energy sector represents the biggest contributor to global climate change. The concurring efforts to decarbonise electricity and heat generation contribute to the ongoing expansion of renewable energy systems.  The European wind power (WP) capacity is expected to triple by the year 2030, with onshore wind farms accounting for over 80% of new installations. This upswing entails critical demands for construction materials, shifting environmental burdens to the construction phase, compared to the use-phase hotspot of fossil resources. To counteract these magnified impacts, emerging innovations are disrupting conventional wind turbine (WT) technologies. To assess these developments, this study evaluates the future environmental impacts of WP production in Sweden using the emerging prospective life cycle assessment (pLCA) methodology. Six explorative foreground scenarios are developed for a generic Swedish WP plant in the year 2050. The scenarios build on projected national capacity developments, as well as identified key processes of hydrogen-based steel and concrete, as well as wooden WT towers. In addition, the application and propagation of the integrated assessment model REMIND-SSP2-NDC-2050 is deployed to project socio-economic changes in the background system.   Compared to the reference year 2020, all six scenarios show clear improvements of the climate change contribution. Especially “green” materials and wood towers promise significant future potential to accelerate a sustainable transition of Swedish WP production. The combined introduction of green steel, concrete, and hydrogen results in the overall best environmental performance, reducing the global warming potential by 47% from 6,3 g CO2eq per kWh in 2020 to 3,34 g CO2eq per kWh in 2050. However, burden-shifting occurs in particular for cancerous human toxicity and the occupation of agricultural land. While inheriting only 8% higher GWP, the wood tower scenario avoids the shifted effect on human toxicity but increases land occupation and terrestrial acidification even further. For all six scenarios, critical pressures emerge for non-fossil elements resulting from the growing demand for permanent magnet materials. The study’s results highlight a promising outlook for Swedish WP production by 2050 and the corresponding importance of pLCA to facilitate a sustainable transition of the energy sector. / Energisektorn är den sektor som bidrar mest till den globala klimatförändringen. De samtidiga insatserna för att minska koldioxidutsläppen från el- och värmeproduktion bidrar till den pågående utbyggnaden av förnybara energisystem.  Den europeiska vindkraftskapaciteten (WP) förväntas tredubblas fram till år 2030, och vindkraftsparker på land står för över 80% av de nya installationerna. Detta uppsving medför en kritisk efterfrågan på byggmaterial, vilket innebär att miljöbelastningen flyttas från användnings- till byggfasen. För att motverka dessa ökade effekter finns det nya innovationer som förändrar den konventionella tekniken för vindkraftverk (WT). För att bedöma denna utveckling utvärderas i denna studie den framtida miljöpåverkan från produktionen av vindkraftverk i Sverige med hjälp av den nya prospektiva livscykelanalysmetoden (pLCA). Sex explorativa förgrundsscenarier utvecklas för en generisk svensk WP-anläggning år 2050. Scenarierna bygger på förväntad nationell kapacitetsutveckling, samt identifierade nyckelprocesser för vätgasbaserat stål och betong, samt WT-torn av trä. Dessutom används tillämpningen och spridningen av den integrerade utvärderingsmodellen REMIND-SSP2-NDC-2050 för att projicera socioekonomiska förändringar i bakgrundssystemet.   Jämfört med referensåret 2020 visar alla sex scenarierna tydliga förbättringar av bidraget till klimatförändringarna. Särskilt ”gröna” material och trätorn har en betydande framtida potential för att påskynda en hållbar omställning av svensk WPproduktion. Det kombinerade införandet av grönt stål, betong och vätgas resulterar i den övergripande bästa miljöprestandan, vilket minskar den globala uppvärmningspotentialen med 47% från 6,3 g CO2eq per kWh 2020 till 3,34 g CO2eq per kWh 2050. Det sker dock en omfördelning av bördorna, särskilt när det gäller cancerframkallande toxicitet för människor och ianspråktagande av jordbruksmark. Trätornsscenariot, som endast har 8 % högre GWP, undviker rebound-effekten för humantoxicitet men ökar markanvändningen och försurningen av marken ytterligare. För alla sex scenarierna uppstår ett kritiskt tryck på icke-fossila grundämnen till följd av den växande efterfrågan på permanentmagnetmaterial. Studiens resultat belyser en lovande utsikt för svensk WP produktion fram till 2050 och den motsvarande betydelsen av pLCA för att underlätta en hållbar övergång av energisektorn.

Untersuchungsziel: Untersucht wurden Auswirkungen einer ambulanten orthopädischen Rehabilitation nach der Implantation einer Hüft- bzw. Knieendoprothese auf die individuelle Lebensqualität. Um zu erkennen, ob Zusammenhänge von individuellen Parametern wie Geschlecht, Alter, Bildungsstand und dem Rehabilitationsverlauf bzw. –ergebnis bestehen, wurden medizinisch-funktionelle und psychosoziale Daten erhoben, sowie ergänzende Variablen durch Schichtenindices und mittels eines strukturierten Interviews erfasst. Methode: Systematische Datenerhebung von medizinisch funktionellen (Gelenkbeweglichkeit, Muskelkraft) und psychosozialen (Aktivitäten des täglichen Lebens) Daten von n=60 Pat. mit Knie-TEP und n=61 Pat. mit Hüft-TEP zu vier Messzeitpunkten (Anfang Reha=t0, Ende Reha=t1, 6 Monate nach Reha= t2 und 24 Monate nach Reha= t3) und strukturiertes Interview zur Erfassung von soziodemographischen Merkmalen, Motivation und Behandlungszuversicht. Analysemethoden: Signifikanzanalyse und Berechnung der Effektstärke (Cohens d) der Veränderungen zwischen t0 – t1 für abhängige Stichproben (getrennt nach Indikation), Längsschnittdarstellung der funktionellen und psychosozialen Parameter mit deskriptivstatistischen Analysen getrennt nach Indikation und Geschlecht. Ergebnisse: Für beide Indikationen ergaben sich hohe Effekte für Verbesserungen der funktionellen Parameter und mittlere (teilhabebezogen) bzw. hohe (aktivitätsbezogen) Effekte bei den psychosozialen Parametern am Ende der Rehabilitation. Die teilstandardisierten Rehabilitationsmaßnahmen wirken sich indikations- und geschlechtsbezogen unterschiedlich aus. Unter Beachtung der psychophysischen Leistungsvoraussetzungen und sozialen Rahmenbedingungen ist die ambulante Rehabilitation gut geeignet für Patienten im höheren Lebensalter. / Study objective: Effects of an outpatient orthopedic rehabilitation after the implantation of a hip or knee replacement on the individual quality of life were studied. In order to analyze the existence of significant relationships between individual parameters such as gender, age, education and the rehabilitation outcome medical-functional and psychosocial data were collected, and additional layers of indices and variables by using a structured interview were applied. Method: Systematic data collection from medical functional (joint mobility, muscle strength) and psychosocial (activities of daily living) data of n = 60 patient with total knee replacement and n = 61 patient with total hip replacement to four time points (beginning of rehabilitation = t0, end rehab = t1, t2 = 6 months after rehabilitation and 24 months after discharge = t3) and structured interview for socio-demographic characteristics, motivation and confidence in treatment Analysis: Significance analysis and calculation of effect size (Cohen''s d) of the changes between t0 and t1 for dependent samples (separated by indication), longitudinal section view of the functional and psychosocial parameters with descriptive-statistical analyses apart from indication and sex Results: For both indications high effects of improvement in functional parameters, mean effects (participatory based) and high (activity-related) effects on the psycho-social parameters at the end of rehabilitation could be identified. The semi-standardized rehabilitation measures had shown differences by indication just like gender. In accordance with the psychophysical performance conditions and social environment outpatient rehabilitation is well suited for patients in advanced age.

In der vorliegenden tierexperimentellen Studie wurde die Frakturheilung an der diaphysären Schafstibia mit dem Fixateur intern zur Plattenosteosynthese und zur unaufgebohrten Marknagelung verglichen. Zu diesem Zweck wurde ein neues, geschlossenes Frakturmodell mit Weichteilschaden entwickelt und in einer ersten Versuchsreihe validiert. In den anschließenden beiden Hauptversuchen erfolgte der direkte Vergleich des Fixateur intern zu beiden anderen Stabilisierungsverfahren. Zur Beurteilung der Frakturheilungen wurden radiologische, histologische und biomechanische Messungen, sowie in vivo Belastungsmessungen beider Hinterläufe der Schafe durchgeführt. Im Vergleich zur Plattenosteosynthese ergab sich eine schnellere Frakturheilung nach Fixateur intern Stabilisierung. Diese Vorteile zeigten sich nach 12 Wochen mit signifikanten Unterschieden in den biomechanischen und histologischen Resultaten. Durch die Beinbelastungsmessungen konnte ausgeschlossen werden, daß diese Ergebnisse auf mögliche Unterschiede in dem Belastungsverhalten der Tiere und somit auf unterschiedliche mechanische Kallusstimulation zurückzuführen sind. Im Vergleich zur Marknagelung wurden keine signifikanten Unterschiede in den biomechanischen Messungen festgestellt. In der histologischen Auswertung fand sich zu beiden Zeiträumen eine gleiche Kallusmenge mit vergleichbaren mineralisierten Anteilen. Unterschiede zeigten sich nur in dem Verhältnis endostaler zu periostaler Kallusbildung. Diese Ergebnisse wurden mit den ersten klinischen Resultaten von zwei multizentrischer Studien zur Anwendung von Fixateur intern Systemen in Verbindung gesetzt. Den experimentellen und klinischen Ergebnissen zu Folge, ist der Fixateur intern aus biologischer und biomechanischer Sicht der Plattenosteosynthese überlegen, und stellt zur Marknagelung - insbesondere im metaphysären Bereich - eine sichere Alternative. / In the presented study fracture healing of the sheep tibia treated with an internal fixator were compared to conventional plate osteosynthesis and intramedullary nailing. For that reason a new fracture model with a reproducible closed soft tissue damage were developed and validated in a pilot study on the sheep tibia. In both main experiments a direct comparision of the internal fixator were preformed to one of the other stabilization options. Fracture healing were ranked by radiological, histological and biomechanical data, as well as in vivo measurements of both hind legs of the sheep. In comparison to conventional plating a more rapid healing of the fracture were observed after internal fixator stabilization. Those differences were significant for the biomechanical as well as the histological data after 12 weeks. However, in comparision to intramedullary unreamed nailing no significant differences were detected in respect to biomechanical stiffness and strength. In the histological measurements a similar amount of the overall callus with a similar grade of bone mineralisation were present after 6 as well as after 12 weeks. Only the relation between endostal and periostal callus differed between the internal fixator and the nailing group. Those experimental results were correlated with the first clinical results of two multicenter studies using the new internal fixator systems. Based on the experimental and the clinical results, the internal fixator is superior compared to conventional plate osteosynthesis in respect to the biology and biomechanics, and seems to be a safe alternative - especial in the metaphysis area - to intramedullary nailing.

Made available in DSpace on 2016-04-26T20:20:27Z (GMT). No. of bitstreams: 1 Flavia Lorena Peixoto Holanda Brumatti.pdf: 745135 bytes, checksum: 49f734af1d6cdb46b982cca7f1f79611 (MD5) Previous issue date: 2011-10-05 / This paper is intended to analyze the doctrine of the prospective overruling os the Courts decisions, focused on the principle of the legal certainty. We understand that the Brazilian legal system only has protection mechanisms in cases that there is change of understanding at the administrative or legislative level. However, there is not a way to avoid the changes of understanding in the judiciary level, what may lead to a legal instability in the behavior of citizens. That is because citizens base their behavior according to the positions of the pacified jurisprudence. But, if such positions change abruptly, there is no instrument to facilitate the people have their rights preserved, since the new decision, as a rule, has retroactive effect. In this scenario, we believe that the modulation of the effects of decisions might be used for such cases, so that there is the prospect of the effects of the judgment for all acts performed by citizens, especially in the taxation, preserving, the legal certainty which shall be given by the Government / Este trabalho tem o objetivo de analisar o instituto da modulação dos efeitos das decisões dos Tribunais, voltando a atenção para a segurança jurídica dos cidadãos. Entendemos que o sistema jurídico brasileiro possui somente mecanismos de proteção nas hipóteses em que existe alteração de entendimento na esfera administrativa ou na esfera legislativa. No entanto, não há, atualmente, uma forma de se precaver das alterações de entendimentos do Poder Judiciário, o que pode acarretar uma situação de piora do estado dos jurisdicionados. Isto porque, os cidadãos pautam suas condutas de acordo com os posicionamentos pacificados na jurisprudência. Contudo, se tais posicionamentos são alterados de forma abrupta, a princípio não existe qualquer instrumento que possibilite que os jurisdicionados tenham seus direitos preservados, já que a nova decisão, em regra, possui efeitos retroativos. Neste cenário, entendemos que a modulação dos efeitos das decisões deve ser utilizada justamente nestas hipóteses, fazendo com que haja a prospecção dos efeitos do julgamento, para que todos os atos praticados pelos cidadãos, principalmente na esfera tributária, sejam preservados, garantindo-se, assim, a segurança jurídica que deve ser conferida pelo Poder Público

L’attractivité des territoires vis-à-vis des investissements directs étrangers constitue, avec l’ouverture accrue des espaces économiques et politiques, un élément clé de l’intensification des flux d’échanges et d’investissements.Pour tous les pays et, plus particulièrement, pour ceux ne disposant pas d’un marché national important, l’établissement d’un diagnostic d’attractivité et la détermination d’axes prioritaires de développement constituent une démarche fondamentale applicable particulièrement à l’exemple du Luxembourg, une économie considérée comme une petite économie mature ouverte (PEMO).A travers cette recherche, on s’attachera à appliquer et à adapter un modèle d’analyse des fondements de l’attractivité, puis un modèle de détermination des orientations économiques et institutionnelles à privilégier.Cette recherche conduit à définir une démarche prospective structurée, appliquée à la PEMO considérée :- en partant de l’établissement d’une liste de déterminants de compétitivité et d’attractivité ayant potentiellement trait à une PEMO en général, validée ensuite pour le cas concret du Luxembourg par un panel de décideurs ;- en permettant l’établissement d’un diagnostic d’attractivité portant sur la situation actuelle de la PEMO considérée ;- pour déboucher sur la détermination d’activités prioritaires et de profilsd’investisseurs directs étrangers à privilégier, dans un « espace de référence » géo - sectoriel reconsidéré.Cette recherche devrait permettre d’identifier les secteurs d’investissement les plus attractifs pour les entreprises étrangères dans une PEMO comme le Luxembourg. / Together with increased economic and political openness, a location’s or territory’s attractiveness and competitiveness for foreign direct investment (FDI) are key elements for intensifying investment and trade flows.For countries, especially those without a national market of significant scale, establishing a way to identify and analyse priorities for economic development is fundamental.This research defines a general analytical framework applicable to the concepts of attractiveness and competitiveness, and, building on this framework, develops a specific model that could assist key institutions as to identify their preferred orientations in the specific context of an economy considered as a small open mature economy (SOME), in particular, Luxembourg.This research will lead to the definition of a prospective structured approach by:- providing a list of factors which potentially influence the competitiveness and attractiveness of SOMEs; this list having been validated with respect to Luxembourgby national decision makers;- establishing a method for analysing the current situation regarding attractiveness and competitiveness in Luxembourg; and- identifying priority sectors for FDI that could be targeted in a specific location/territory of reference such as Luxembourg.

La majorité des personnes utilisatrices de drogues par injection (PUDI) contracteront le virus de l’hépatite C (VHC), les mettant à risque accru de complications hépatiques graves et parfois mortelles. Les comportements les plus risqués pour l’acquisition du VHC incluent le partage de matériel d’injection et l’injection à haute fréquence. Un facteur jusqu’ici négligé dans l’évaluation du risque de VHC est l’aspect dynamique de l’injection, c.-à-d. la manière dont elle varie dans le temps, incluant l’effet des périodes sans injection et celui des changements dans la fréquence d’injection. On reconnaît également l’effet délétère que l’instabilité résidentielle peut avoir sur le risque de VHC, bien que les mécanismes sous-jacents soient mal compris. Cette thèse s’intéresse à l’effet des variations temporelles de l’injection sur le risque de VHC, et à la manière dont la fréquence d’injection évolue en concomitance avec les conditions résidentielles dans le temps, afin d’aider au développement de nouvelles stratégies de prévention du VHC. Les données ont été recueillies entre mars 2011 et juin 2016 dans la Hepatitis Cohort, une cohorte de PUDI suivies trimestriellement à Montréal, au Québec. Une première analyse a évalué l’effet des périodes sans injection de trois mois ou moins sur le risque de VHC sur 916 personnes-années de suivi, par régression de Cox (N=372). Celle-ci suggère que les PUDI présentant des périodes sans injection courtes (3/3 mois sans injection) et sporadiques (1/3 ou 2/3 mois sans injection) sont respectivement 76% et 44% moins à risque de VHC que celles s’injectant de manière persistante (0/3 mois sans injection). Une deuxième analyse a utilisé la modélisation de trajectoires fondée sur le groupement pour identifier cinq types distincts de trajectoires de fréquence d’injection suivies sur une année, lesquels ont ensuite été comparés en termes d’incidence du VHC sur des périodes de suivi allant de 71 à 355 personnes-années (N=386). Les résultats suggèrent que les PUDI dont la fréquence reste élevée (injection fréquente) ou change dans le temps (croissante, décroissante) sont à plus haut risque de VHC que celles s’injectant à basse fréquence (sporadique, peu fréquente). Une dernière analyse a identifié trois types de trajectoires de stabilité résidentielle suivies sur un an (persistance, déclin, amélioration; N=386), lesquels ont été évalués en association avec les trajectoires de fréquence d’injection suivies simultanément. Les résultats suggèrent qu’il existe un lien entre l’amélioration des conditions résidentielles et la diminution de la fréquence d’injection, mais aussi que la probabilité d’injection à fréquence croissante est plus élevée chez les PUDI maintenant des conditions résidentielles stables que celles chez qui elles s’améliorent. Collectivement, les résultats ont de nombreuses implications en termes de prévention du VHC. Cliniquement, l’instabilité de la fréquence d’injection semble être un facteur de risque à monitorer régulièrement. En termes de santé publique, les interventions favorisant l’engagement dans des périodes sans injection ou le maintien d’une basse fréquence d’injection pourraient être prometteuses. Enfin, les stratégies visant l’amélioration des conditions résidentielles pourraient éventuellement aider les PUDI à réduire leur fréquence d’injection, mais être insuffisantes pour maintenir celle-ci à basse fréquence une fois la stabilité atteinte. / The majority of people who inject drugs (PWID) will become infected with hepatitis C virus (HCV), placing them at risk of serious and sometimes fatal liver complications. Injecting behaviours with higher risk of HCV transmission include injecting equipment sharing and high frequency injecting. One factor that has been overlooked when assessing HCV acquisition risk is the dynamic aspect of drug injecting, i.e., how drug injecting varies over time, including the role of injecting cessation episodes and that of changes in injecting frequency. Moreover, there is growing recognition of the deleterious effect unstable housing can have on HCV acquisition risk, although the underlying mechanisms are not yet fully understood. This thesis examines how temporal variations in drug injecting relate to HCV acquisition risk and further explores how housing conditions and injecting frequency evolve together over time, for the purposes of contributing to the development of novel HCV prevention strategies. Data were collected between March 2011 and June 2016 in the Hepatitis Cohort, a prospective cohort study of PWID interviewed and tested for HCV infection at three-monthly intervals in Montréal, Québec. A first analysis examined the effect of injecting cessation episodes of three months or less on the risk of contracting HCV during 916 person-years of follow-up, using Cox regression (N=372). Results suggest that PWID with short injecting cessation episodes (3/3 months without injecting) or sporadic injecting cessation episodes (1/3 or 2/3 months without injecting) are 76% and 44% less at risk of contracting HCV than those with persistent injecting (0/3 months without injecting), respectively. A second analysis used group-based trajectory modeling to identify five distinct types of one-year injecting frequency trajectories and compared these in terms of HCV incidence over follow-up periods ranging from 71 to 355 person-years (N=386). Findings suggest that PWID injecting with consistently high frequencies (frequent) or time-varying frequencies (increasing, decreasing) are at greater HCV acquisition risk compared with those maintaining low injecting frequencies (sporadic, infrequent). Finally, a third analysis identified three types of one-year housing stability trajectories (sustained, declining, improving) and examined their associations with concomitant injecting frequency trajectories (N=386). Findings suggest an association between improving housing stability and decreasing injecting frequency, but also a higher probability of increasing injecting frequency among PWID who maintain housing stability compared to those that improve it. Collectively, these findings have numerous implications for HCV prevention. Clinically, instability in injecting frequency appears to be a risk factor that should be monitored regularly. From a public health perspective, interventions that promote engagement in injecting cessation episodes or maintenance of low injecting frequency may be promising. Finally, strategies aimed to improve housing stability may help PWID to decrease their injecting frequency but may not be sufficient to help them maintain low injecting frequencies once housing stability is achieved.

This study attempted to design and implement an intervention programme to improve the self-concepts and attitudes of prospective primary school teachers. The possible effects of the programme were researched by means of a combined quantitative and qualitative approach. A questionnaire to determine the effectiveness of the programme was also designed. Important findings of this study are that: (a) the Cronbach Alpha Coefficient indicated a 0,9 reliability of the designed questionnaire; (b) the average self-concepts of prospective teachers improved after the intervention programme was implemented, though not significantly and (c) the self-concepts of prospective teachers not majoring in Mathematics also improved after the intervention, though not significantly. A focus group interview was conducted to improve the intervention programme. On the basis of the responses of the participants in the focus group interview as well as of the quantitative study and of the literature reviewed, an improved version of the intervention programme was designed. According to the research, the programme should include: cooperative learning; everyday life contexts; manipulatives; hands-on activities, encouraging the asking of questions; a positive relationship between lecturer and student; writing assignments before doing a new topic; content relevance; a positive communication of assessment; games; various approaches to solving problems; understandable language; gender sensitivity and positive role modeling. The intervention programme implemented in this study was tested over a period of three months; hence the recommendation in this research for the replication thereof over a longer period. The study further recommends that since the study was conducted in one college of education only, there is a need for it to be conducted in a number of colleges, in order to elicit a broader and more representative picture of the impact of the intervention programme. The findings of this study advocate the need to combine both quantitative and qualitative research in studies: the results of the quantitative research did not conclusively indicate a positive impact of the intervention programme. However, the qualitative research saw respondents expressing improved confidence and attitudes. / Psychology of Education / D. Ed. (Psychology of Education)

民主政治運作過程中，當主政者無法滿足選民需求時，選民理所當然會以選票表達其自主性，找一個更符合其需求的政黨作為治理國家的代理人（總統）。政黨輪替就成為選民選擇最佳代理人的手段。政黨輪替的本身，就是一種權力交替與權力制衡，特別是在執政黨交不出政績的時候，政黨輪替就是一個民主的制裁機制，更是一個國家走向民主政治的重要指標。 影響選民決定更換治國代理人的投票抉擇因素，主要有政黨因素、候選人因素，抑或是議題因素。無論在美國與其他西方國家，甚至在已開發或開發中國家都已經獲得印證。當選民利用參考標的進行投票，選民的總統選舉投票結果將會匯集成決定最後政權誰屬。把票投給執政黨的候選人，還是把票投給在野政黨的候選人，不僅攸關個別政黨與候選人的選舉成敗，而且還影響到統治權力歸屬，甚至會牽動政黨輪替執政的可能性，其重要性，不言而諭。也正因如此，政治學者亟思理出選舉各黨勢力消長的軌跡，試圖描繪出選民投票抉擇的決定如何影響政治權力的轉移。 本文的目的，是研究選民投票抉擇的一般原則應用到總統選舉結果「政權轉移」或「政黨輪替」這個重要的主題，針對可能造成多數選民由投票支持原有執政黨轉而投票支持原有最大在野黨取得執政權的成因進行討論。台灣與墨西哥這兩個長久以來一黨威權獨大的政權，卻同時在西元二○○○年發生政黨輪替的現象。有關選民選擇支持原有最大在野黨取得執政權的成因，主要從三個面向進行討論： 首先，政黨認同因素，選民政黨認同發生改變所引發的政黨認同重組現象，讓原本獲得多數選民支持的執政黨，因為政黨重組的因素變成僅吸引少數選民支持的在野黨；相反地，原本僅有少數選民支持的在野黨，因為政黨重組的關係變成吸引多數選民支持的執政黨。其次，候選人因素，候選人人格特質、能力與對候選人情感溫度等因素，讓多數選民受候選人這個短期因素所影響而選擇支持最大在野黨執政。最後，議題因素，選民的展望性評價與重大議題中的改革議題，因選民希冀更換原有執政黨，由最大反對黨執政，能夠改變趨於日益不振的經濟現況，並透過大幅改革能改變舊政府的缺失，期望新政府能夠振衰起弊。 / In the democratic operation process, when the director is unable meet the citizens need, the citizen would express their autonomy by votes. Looking for one (or political party) who could conform to the citizens demand takes the government (president) of this country. Party rotation is a democratic sanction mechanism. That is an important indicator for country achieving the democracy. There are some factors must be considered while establishing voting behavior models in the turnover elections. There mainly are the party identification or party preference, the candidate image, and policy orientation. My thesis finds that party realignment is the key variable for 2000 Mexican presidential election, but 2000 Taiwan presidential is not. Candidate image or candidate personality centers on competence, likeability, honesty, reliability, and understanding people’s needs. Candidate evaluation refers to an overall assessment of the candidates: it is measured by way of “feeling thermometers”. My study found that candidate image is an important factor in determining Mexican and Taiwan voters choosing the opposition party candidate for a new president. The results shows that the policy issues, including prospective economic voting and the salience issue of change influence people’s voting choices.

Objetivos: Malformação de Chiari do tipo I (MC-I) é a principal doença malformativa congênita da junção craniovertebral, manifestando-se com ampla variedade de sinais e sintomas neurológicos. A melhor técnica cirúrgica a ser empregada no tratamento dos pacientes com malformação de Chiari do tipo I é ainda controversa. A descompressão das estruturas da fossa craniana posterior com plástica de ampliação dural é considerada procedimento padrão. Embora efetiva e de baixa morbidade, a craniectomia occipital isolada, sem abertura e ampliação dural, implica maior taxa de recidiva dos sintomas. Métodos que selecionam os pacientes quanto a necessidade da duroplastia não foram estabelecidos. O presente trabalho avalia a eficácia da mensuração intraoperatória da velocidade do fluxo do líquido cefalorraquidiano através da ultrassonografia (USG) na seleção da técnica cirúrgica a ser utilizada. Métodos: Foram analisados de forma prospectiva 49 pacientes submetidos à cirurgia para MC-I. A indicação de craniectomia da fossa posterior associada ou não à plástica de ampliação da dura-máter baseou-se na velocidade do fluxo do líquido cefalorraquidiano, mensurada pela ultrassonografia intraoperatória. Dor cervical, cefaleia e qualidade de vida foram avaliadas antes e após o tratamento cirúrgico. Resultados: Dos 49 pacientes incluídos, 36 pacientes (73%) apresentavam fluxo do líquido cefalorraquidiano superior a 3 cm/s e não foram submetidos a duroplastia ampliadora. Nos 13 (27%) pacientes com fluxo inicial inferior a 3 cm/s, indicou-se craniectomia occipital com duroplastia de ampliação. Não houve diferença significativa entre os dois grupos com relação aos parâmetros estudados. Conclusão: A ultrassonografia intraoperatória com avaliação da dinâmica e velocidade do fluxo do líquido cefalorraquidiano da junção craniovertebral auxilia a indicação de duroplastia durante descompressão da fossa craniana posterior em pacientes adultos com MC-I / Objectives: Chiari malformation Type I (CM-I) is the main congenital malformation disease of the craniovertebral junction, and may be responsible for a variety of neurological symptoms. The ideal surgical technique used to treat patients with CM-I is still controversial. Invasive procedures that enters CSF space and are associated with dural repair, are considered the gold standard. Although effective and less morbidity, isolated bone decompression without dural opening, implies greater recurrence of symptoms. Objective parameters to select patients, who need or not to have a duroplasty performed, have not been established. Our study evaluates the efficacy of intra-operative CSF flow measurement through the use of ultrasonography (USG) as a determining parameter in the selection of these patients. Methods: We analyzed prospectively 49 posterior fossa surgeries for patients with CM-I. Patients underwent decompressive surgery with or without opening of the dura mater after conducting USG intra-operatively with measured flow rate, being adopted 3cm/s flow rate as a determining value. The quality of life before and after surgery and the improvement of neck pain and headache were the parameters evaluated. Results: Of the 49 patients enrolled, 36 patients (73%) had adequate CSF flow above 3 cm / s and have not undergone duroplasty. In 13 (27%) patients with initial flow < 3 cm / s an opening in dura mater was performed together with duroplasty. There was no significant difference between the two groups regarding the parameters studied. Conclusion: Intraoperative ultrasound with measurement of CSF flow, having a flow of 3 cm / s as cut-off, allows the proper selection of patients with CM-I that can have a less invasive surgery with bone decompression without duroplasty

Introdução: A esclerodermia é rara doença do tecido conectivo que se manifesta através da esclerose cutânea e variável acometimento sistêmico. Duas categorias de esclerodermia são conhecidas: esclerose sistêmica, caracterizada por esclerose cutânea e acometimento visceral e a esclerodermia localizada ou morfeia que classicamente apresenta evolução benigna e autolimitada, confinada a pele e/ou tecidos subjacentes. Estudos recentes demonstram que a forma localizada possa eventualmente apresentar acometimento de órgãos internos e morbidade variável. Objetivo: Neste estudo objetivamos determinar as características demográficas, a prevalência de manifestações sistêmicas e alterações laboratoriais, bem como a associação com doenças autoimunes, em pacientes com esclerodermia da face. Métodos: Pacientes com esclerodermia localizada, incluindo os casos de esclerodermia em golpe de sabre, síndrome de Parry-Romberg e morfeia em placas com acometimento facial, foram avaliados e submetidos à investigação neurológica, incluindo exame clínico neurológico e ressonância magnética de crânio, e avaliação oftalmológica. Após 3 anos, o subgrupo de pacientes disponível para seguimento foi ressubmetido à ressonância magnética. Resultados: Foram estudados 34 pacientes com esclerodermia localizada da face. Deste total, 64,7% apresentavam uma ou mais manifestações extracutâneas, sendo cefaleia a queixa mais frequente, encontrada em 61,8% dos pacientes. Dos 23 pacientes submetidos à avaliação neurológica, 56,5% apresentaram alterações neurológicas possivelmente associadas à esclerodermia. Alterações à ressonância magnética foram observadas em 50% dos casos. O achado mais frequente foi a presença de lesões parenquimatosas com alteração de sinal em 50% dos pacientes. Dos pacientes que apresentavam alteração neurológica, 80% também apresentavam alguma alteração à ressonância magnética. Doze pacientes foram ressubmetidos a novo exame após 3 anos. Em todos os pacientes os achados de imagem se mantiveram inalterados. Durante esse intervalo de 3 anos, 25% dos pacientes apresentaram sinais de atividade da esclerodermia. Quanto à avaliação oftalmológica, 67,9% dos pacientes avaliados apresentaram alteração, sendo os achados mais frequentes a ocorrência de alterações orbiculares da esclerodermia (20,6%) e xeroftalmia (10,7%). Conclusão: Pacientes com esclerodermia localizada da face apresentam alta prevalência de alterações neurológicas e oftalmológicas. Baseado nestes achados, sugerimos que todos os casos de esclerodermia localizada da face devam ser detalhadamente examinados quanto à presença de alterações sistêmicas / Introduction: Scleroderma is a rare connective tissue disease that manifests as skin sclerosis and variable systemic involvement. Two categories of scleroderma are known: systemic sclerosis, characterized by cutaneous sclerosis and visceral involvement and localized scleroderma or morphea which classically presents benign evolution and selflimited, confined to the skin and / or underlying tissue. Recent studies show that the localized form may possibly course with involvement of internal organs and variable morbidity. Objective: This study aimed to determine the demographic characteristics, the prevalence of systemic manifestations and laboratory findings, as well as the association with autoimmune diseases, in patients with scleroderma of the face. Methods: Patients with localized scleroderma, including cases of scleroderma en coup de sabre, Parry-Romberg syndrome and morphea plaque with facial involvement were evaluated and underwent neurological examination, including neurologic examination and magnetic resonance imaging, and ophthalmology evaluation. After 3 years, the subgroup of patients available for follow-up was subjected again to MRI. Results: We studied 34 patients with localized scleroderma of the face. Of this total, 64,7% had one or more extracutaneous manifestation, headache being the most frequent complaint found in 61,8% of patients. Of the 23 patients undergoing neurological evaluation, 56,5% had neurological changes possibly associated with scleroderma. MRI changes were observed in 50% of cases. The most frequent was the presence of parenchymal lesions with signal alteration in 50% of patients. Of the patients who had neurological deficits, 80% also had a change to MRI. Twelve patients were subjected again to another MRI scan after 3 years. In all patients, imaging findings were unchanged. During this interval of 3 years, 25% of patients showed signs of activity of scleroderma. As for ophthalmologic evaluation, 67,9% of patients showed abnormalities, with the most frequent findings being the occurrence of orbicular changes of scleroderma (20.6%) and xerophthalmia (10.7%). Conclusion: Patients with localized scleroderma face have a high prevalence of neurological and ophthalmological changes. Based on these findings, we suggest that all cases of localized scleroderma of the face should be thoroughly examined for the presence of systemic changes