Adverse Effects of State-building on Democracy in Georgia

"The Freedom House letter suggests that there is a strong correlation between democratic deficits in Georgia and President Saakashvili’s ability to go to war with Russia. The letter’s implication is obvious: had more robust democratic institutions been in place, the war between Russia and Georgia might not have occurred. In this paper, I argue that U.S. government assistance to Georgia since 2003 has failed to support robust democratization, focusing too much on strengthening the executive branch of the Georgian government. Once Saakashvili took office, Washington reduced funding to critical democratization programs, especially those that supported independent media and civil society organizations. This shift in U.S. assistance, which contributed to the slowdown of democratic consolidation in Georgia, demonstrates that U.S. aid is critical to Georgia’s political development."--from pages 69-7

The Human Factor in Blockchain Ecosystems: A Sociotechnical Framework

As blockchain development continues at an ever-increasing pace, an increasing number of individual actors and organizations throughout entire economies get into contact with the technology. Furthermore, the growing collaboration of companies, customers, suppliers, and other actors is evolving into a multilateral network between the parties engaged with the technology. Therefore, to understand blockchain-based business models and innovations, it is necessary to understand human interactions within blockchain ecosystems. Consequently, this paper offers new insights concerning the role of human actors within blockchain ecosystems. For this purpose, the structure within and around the Ethereum-blockchain is analyzed using existing literature on the Ethereum ecosystem and Sociotechnical systems. The analysis results are then placed in their context and summarized in a framework for comparable ecosystems

Welche Zukunft hat die Blockchain-Technologie in der Energiewirtschaft?

Die Blockchain-Technologie erfuhr die Spitze ihres ersten großen Hypes im Jahr 2017. Bei der Blockchain-Technologie handelt es sich um ein dezentrales elektronisches Register für digitale Transaktionen. Zu den Eigenschaften der Technologie zählen u. a. eine hohe Manipulationsresistenz, welche Vertrauen in digitale Daten erzeugen kann, sowie die Möglichkeit, Prozesse und Transaktionen, ohne Intermediär abzuwickeln. Diese besonderen Eigenschaften ermöglichen die Entstehung eines "Internets der Werte". Während Kryptowährungen den bekanntesten Anwendungsfall darstellen (oft auch "digitale Währungen" oder "Krypto-Token" genannt), sind seit der Einführung der Technologie im Jahr 2008 viele weitere Anwendungsfälle diskutiert worden. Dabei bietet sich die Technologie nicht als Universallösung für jegliche Problemstellungen an. Das nachfolgende Diskussionspapier soll aufzeigen, in welchen Branchen sich die Technologie bereits etabliert hat, welche allgemeinen Missverständnisse die Technologie umgeben und wo ihre energiewirtschaftlichen Einsatzmöglichkeiten liegen. Zudem soll aufgezeigt werden, welche technologieunabhängigen Hürden den Einsatz der Technologie erschweren

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Health Literacy: Germany in the Digital Race to Catch Up Introduction of Technological Innovations is not Sufficient

Schmidt-Kaehler S, Dadaczynski K, Gille S, et al. Gesundheitskompetenz: Deutschland in der digitalen Aufholjagd. Einführung technologischer Innovationen greift zu kurz. Das Gesundheitswesen . 2021;83(5):327-332.Recently, several acts have been passed by the German Ministry of Health to drive the digital transformation of the healthcare system. These aim at far-reaching innovations to improve care and increase the efficiency of the healthcare system. At the same time, the demands on users in dealing with digital applications and information are increasing. Digital health literacy is thus becoming particularly relevant. However, available studies show that the digital health literacy of the population in Germany is often limited. This paper explores challenges, gaps, and prospects regarding the implementation of these new digital health policies, particularly in terms of the implications for improving digital health literacy and increasing user involvement and participation by providing six major aspects that should be considered. Thieme. All rights reserved