Top PDF Competition in Healthcare: Good, Bad or Ugly?

Competition in Healthcare: Good, Bad or Ugly?

Competition in Healthcare: Good, Bad or Ugly?

A simple dichotomy between competitive and non- competitive markets gets in the way of understanding the nuances of the reality of most healthcare systems which tend not to be at either end of these extremes. The complexity and diversity of competitive markets may be one reason why evidence on their impact, although plentiful, is often conflicting and non-generalisable beyond the specific context in which the evaluation has taken place, explaining perhaps why there are such diverse views on the role of competition. In addition, gathering reliable evidence on the impact of competition is hindered by the lack of robust evaluation frameworks when policies are implemented. Thus, the evidence relating to the English NHS which has, at various times seen elements mainly of supply-side competition introduced, is mixed, contested and likely applicable only in those countries with similar healthcare systems. For instance, the evidence relating to the later stages of the reforms (post 2000) is relevant to markets where prices are fixed by the regulator, and the main focus has been on whether competition in these circumstances has driven up quality. Studies that have strong methodological designs show that areas with greater competition had fewer deaths from myocardial infarction and hence are interpreted as a signal of improved quality. 9,10 Reviews of the evidence from the
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Optimisation of Healthcare Contracts: Tensions Between Standardisation and Innovation; Comment on “Competition in Healthcare: Good, Bad or Ugly?”

Optimisation of Healthcare Contracts: Tensions Between Standardisation and Innovation; Comment on “Competition in Healthcare: Good, Bad or Ugly?”

According to proponents of competition, better performance may emerge from pressure on purchasers to develop innovative contract mechanisms. But competition can damage performance when purchasers lack incentives to encourage value in service provision. The insurance market must be astutely regulated, to transmit the right incentives to the provider sector. Accordingly, contractual evolution might not improve system performance. In multi-payer systems where the effectiveness of risk equalisation is limited, such as in Ireland and Israel, insurers may flourish by risk-selecting profitable patient subpopulations, as noted by Professor Goddard, and this dilutes incentives to craft improved contracts for providers. 8 Risk adjustment is also increasingly
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The good, the bad and the ugly: a study of security decisions in a cyber-physical systems game

The good, the bad and the ugly: a study of security decisions in a cyber-physical systems game

Abstract—Stakeholders’ security decisions play a fundamental role in determining security requirements, yet, little is currently understood about how different stakeholder groups within an organisation approach security and the drivers and tacit biases underpinning their decisions. We studied and contrasted the security decisions of three demographics – security experts, computer scientists and managers – when playing a tabletop game that we designed and developed. The game tasks players with managing the security of a cyber-physical environment while facing various threats. Analysis of 12 groups of players (4 groups in each of our demographics) reveals strategies that repeat in particular demographics, e.g., managers and security experts generally favoring technological solutions over personnel training, which computer scientists preferred. Surprisingly, security experts were not ipso facto better players – in some cases, they made very questionable decisions – yet they showed a higher level of confidence in themselves. We classified players’ decision-making processes, i.e., procedure-, experience-, scenario- or intuition-driven. We identified decision patterns, both good practices and typical errors and pitfalls. Our game provides a requirements sandbox in which players can experiment with security risks, learn about decision-making and its consequences, and reflect on their own perception of security.
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Augmented Reality as a Tool for Promoting the Tourist Value of the Geological Heritage Around Natural Filming Locations: a Case Study in “Sad Hill” (The Good, the Bad and the Ugly Movie, Burgos, Spain)

Augmented Reality as a Tool for Promoting the Tourist Value of the Geological Heritage Around Natural Filming Locations: a Case Study in “Sad Hill” (The Good, the Bad and the Ugly Movie, Burgos, Spain)

Once all the information has been incorporated using the Google Earth application, following the described methodol- ogy, a virtual flight can be generated enabling the observation of the study area prior to the visit. This route can be seen in 3D, using the Google Maps application “Street View” (Fig.5). The geoapp allows improving the performance during the realisation of the pre-designed paleontological route (Fig. 6). The geoapp starts with a welcome message integrated into a photo of the most touristic place, Sad Hill. Then, the main menu appears with different sections of information for each site, and a chat to the exchange of opinions with other regis- tered users that have made the route, are in it or are going to make it. The access to a community for searching the assis- tants and the field guide is also available through an enabled link to Drive. By just entering the personal email, the interest- ed user will have full access to the document containing the activities and the information sheet of each stop (supplemen- tary material).
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Efeito da adição de colesterol sobre a viabilidade e fertilidade de espermatozóides equinos refrigerados

Efeito da adição de colesterol sobre a viabilidade e fertilidade de espermatozóides equinos refrigerados

was divided into four 5 mL aliquots into C and CLC-1.5 groups, kept fresh or cooled for 24 hours at 5 ºC. To induce capacitation, the aliquots were incubated with calcium ionophore at 37 ºC for 3 hours. Acrosome reaction (ACR) analyses were performed by flow cytometer before incubation and at 1 hour, 2 hours and 3 hours of incubation. For experiment 5, 35 mares were used, with 2 cycles of 10 to a GC stallion and 2 cycles of 25 to a BC stallion. After 24 hours of ovulation induction, inseminations were performed using C and CLC-1.5 groups cooled at 5 ºC for 24 hours. According to experiment 1 results, all CLC-treated groups presented greater IMP compared to the respective C group, and the groups CLC-1.5 and CLC-2 presented the best results for sperm kinetics. In experiment 2, the cooling temperature of 5 ºC was superior to 15 ºC for CLC-treated sperm. In experiment 3, both GC and BC stallions were benefited by CLC-1.5 treatment, but BC stallions were greater favored since, in addition to sperm kinetics, there was also an increase in IMP. In experiment 4, there was a delay of capacitation at least 3 hours in fresh spermatozoa and of at least 1 hour in cooled spermatozoa after the addition of CLC-1.5 In experiment 5, the addition of CLC-1.5 significantly improved the BC stallion fertility, but no differences were observed for the GC stallion. Therefore, it is possible to conclude that CLC incorporation is an efficient strategy for equine semen cooling, although it is mainly indicated for BC stallions.
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The impact of product market competition on the decision to outsource with long term contracts

The impact of product market competition on the decision to outsource with long term contracts

Before we proceed with the derivation of the equilibrium, let us make some considerations about the effect of product market competition on financial distress costs. At this stage, we know that financial distress costs are positive as soon as the profit flow at time t = 1 is lower than the required debt payment D. With a monopoly in the downstream market, we showed that only firms outsourcing to the spot market would incur financial distress costs, and this would happen in the bad state (u), due to a higher input price. A long term contract provided the buyer a perfect hedge of input price uncertainty and, at the same time, because the buyer was the only competitor in market A, his profit with the long term contract regime was certain at time t = 0. We found in proposition 2 that under the long term contract regime the uncertainty measure had no effect on the equilibrium price in market A.
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Depression: The role of the self-concept

Depression: The role of the self-concept

A second important point is that there is an important division in the depressive between good and bad, between a positive self and a negative self (e.g. When depres[r]

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The Good, the Bad, and the Tiny: A Simple, Mechanistic-Probabilistic Model of Virus-Nutrient Colimitation in Microbes.

The Good, the Bad, and the Tiny: A Simple, Mechanistic-Probabilistic Model of Virus-Nutrient Colimitation in Microbes.

Phytoplankton account for approximately half of global annual primary production [1]; both phytoplankton and marine bacteria are important components in global biogeochemical cycles and the global ecosystem [2]. Though phytoplankton and other marine microorganisms are regulated simultaneously by bottom-up [3, 4] and top-down control [5], the former frequently a result of nutrient limitation, the latter frequently a result of viral invasion [6], these controls are seldom studied simultaneously. Both grazing effects and nutrient limitation are well-stud- ied [7, 8]; understanding of viral impacts remains poorer [9] but viruses are known to have sig- nificant effects on a vast range of marine microbes; studies include e.g. estimates that 30% of cyanobacterial death is caused by viral lysis [10], or laboratory results showing a 20% increase in viral concentration can halve phytoplankton primary productivity and biomass [11]. Viral a11111
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To see expressions of love from Plato and Avicenna point of view and its implications

To see expressions of love from Plato and Avicenna point of view and its implications

Love in the eyes of the elders, the sensual pleasure and belonging and self-absorption has been introduced as light instinct about the nature, or mind and heart. Then, God has been qualified by the same meaning and of course by removing and abstraction of material and possible defects and margins; therefore MullaSadra writes in Transcendent Wisdom:"The love and synonyms are: delight agree to anything, whether intellectual or sensory delight translations is real and suspicion." Love is the same as passion, but also the extreme case, i.e., when affection for love just is maximum so that his heart and soul of becomes the beloved home and the words of love occur. This love likened to the plant ofAraliaceae that surrounds all stems and branches. Thus, according to Suhrawardi in "Treatise of Love", ifthe passiondevelops extremely, it is called love. The right thing is that truth cannot be defined and extended the love and affection are unknown acquisitions.Another question that philosophers have raised in this regard is the love types. Plato, in his treatise on the feast based on types of love, divided it as "praiseworthy love" and "bad love".The first speaker at the banquet is "Phaedrus" that says: he is the oldest gods and most supportive of mankind which creates intense feelings of pride and a spirit of sacrifice. If an army composed of lovers, it is an invincible army. "Pausanias",the second lecture that distinguishes the sublime and bad love and posts. In his view, bad love has no aim but to quench lust, and as such includes women and young boys as well. "Eryximachus" approved the distinction between two loves.
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THE EUROPEAN UNION AND RUSSIA, COOPERATION OR COMPETITION?

THE EUROPEAN UNION AND RUSSIA, COOPERATION OR COMPETITION?

Researchers that analyzed this concept have not reached an agreement on what power is, how it works, how it can be measured or how to interpret or weigh different empirical results, so that there are many different opinions and contradictions when it comes to both the role and the nature of power. For example, Kenneth Waltz argued that power is based on a number of components, such as "the size of population and territory, abundant natural resources, economic capacity, military strength, political stability and competence" (Waltz, 1979, 131), but emphasizes that "defining the concept of power remains a controversial issue" (Waltz, 1986, 333). Moreover, Robert Gilpin describes power as "one of the most controversial issues in the field of international relations" (Gilpin, 1981, 13), thus pointing out the lack of a consistent and coherent orientation in the literature when it comes to this basic. Gartzke believes that purely theoretical studies do not have enough relevance and legitimacy and therefore it is necessary to supplement them with evidence and empirical analysis (Gartzke, 2001, 11).
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Exploratory study about "Planned obsolescence": a tool for business plans and strategic decisions

Exploratory study about "Planned obsolescence": a tool for business plans and strategic decisions

More than one hundred million of cell phones and three hundred million of PC’s are tossed every year just in North America and while twenty million televisions are bought only twenty thousand are repaired each year. Guiltinan states that between 50-80% of the electronic waste is sent to third world countries (eg. Gana) resulting in enormous environmental damage from lead, mercury and other toxic material. He also demonstrates that there is an inverse correlation between household income and the propensity to dispose things instead of repairing it; supporting even more the tendency of the richest countries to use poor countries as their waste dumps. The environmental concerns are addressed to designers, engineers and marketing & business strategist that undertake the decisions on the materials and components used. The world business council for sustainable development a global association composed by CEO’s of 200 companies, does not include on purpose extending product durability on their list of eco-efficient practices. They believe that repeated purchase is healthy for their lines as well for the public goal of higher levels of employment. Guiltinan also states that companies are not the only ones to be held accountable for resource depletion and e-waste. Consumers also have a big responsibility in it due to poor consumption choices and frivolous needs. This work will also focus on consumer choices and preferences and show that the responsibility is mutual and not only company based.
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‘Holistic mothers’ or ‘bad mothers’? Challenging biomedical models of the body in Portugal

‘Holistic mothers’ or ‘bad mothers’? Challenging biomedical models of the body in Portugal

therapies whenever she had health issues. She had planned to give birth in a hospital, until, in her 30th week of pregnancy, she saw a ‘homeopathic doctor’ who practised anthroposophical medicine (see note 2). He asked her whether she had considered having a home birth, assuring her that her yearlong experi- ence as a yoga practitioner would help her through the birthing experience. Sonia says she remembers having read in a book she had bought when she got pregnant that it was important for the woman to give birth in a place where she felt comfortable and safe. When the doctor mentioned the possibility of giving birth at home, Sonia realised how much better she would feel there, versus in a hospital. Still, she had many doubts, not least because in Portugal women who give birth at home are seen as irresponsible; should an emergency arise, doctors and hospitals are known to treat such woman as a sort of crimi- nal, and will prevent the midwife from participating further in the birthing process. But, Sonia also realised, giving birth at home would enable her to avoid what she considered the excessive medicalisation of birth, as well as vac- cinations and intrusive exams that she thought could negatively affect both her and her baby.
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Competition among health care providers: helpful or harmful?

Competition among health care providers: helpful or harmful?

Authors on behalf of the Expert Panel on Effective Ways of Investing in Health (EXPH): Pedro Pita Barros, Margaret Barry, Helmut Brand, Werner Brouwer, Jan De Maeseneer (chair), Bengt Jo¨nsson (vice- chair), Fernando Lamata, Lasse Lehtonen, Dorjan Marusˇicˇ, Martin McKee, Walter Ricciardi and Sarah Thomson. Marco Varkevisser participated as an external expert in the panel’s working group on competition between health care providers. The opinions of the Expert Panel present the views of the independent scientists who are members of the EXPH and do not necessarily reflect the views of the European Commission or its services.
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Rev. esc. enferm. USP  vol.44 número3

Rev. esc. enferm. USP vol.44 número3

The objective of this qualitative study was to assess the knowledge of community health workers (CHW) with respect to aging and dementia, with the purpose of assisting the implantation of caregiving services focused on dementia, in a city in the State of São Paulo. All ethical guidelines were followed. In all, 51 CHW were evaluated. Semi-structured interviews were con- ducted. The data analysis was based on content analysis. In response to the question, What does elderly mean, for you?, the majority of the workers associated old age with chronologically advanced age and with negative aspects of aging, such as physical and social dependence. With respect to the concept of dementia, the majority of those interviewed defined dementia as a biological problem that affects the brain, compromising memory functions and resulting in dependency. The results demonstrate the need for an educational program for CHW, in the area of gerontology.
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The Effect of Global Political Events in the Arab Spring on Stock Returns: The Case of Turkey

The Effect of Global Political Events in the Arab Spring on Stock Returns: The Case of Turkey

In the 1 st Equation, P represents the actual value of the shares; k represents the expected rate of return from equity investments by the investor; g represents the dividend growth rate and D represents the earnings per share, respectively. Dividend payments, expected rates of return and growth rates that identify the real value of shares are greatly affected by the country’s economic and financial circumstances (Flannery & Protopapadakis, 2002). The real value of the shares is sensitive to the economic and financial situation as well as the political situation of the country. In fact, the indicators or the news presenting the current political situation of a country related to political stability of the system (Annet, 2001), the government ’s response to the sudden policy changes (Minor, 2003, 20), conflicts between religious or social groups (Alon & Herbert, 2009, 129) and expectations related to political developments ( Ada, Bolak & Süer, 2013, 23) will have either positive or negative effects on the earnings 1 and future plans of the companies by providing information about the reliability of the environment, in which the companies have invested. This effect will identify the real value of the shares by affecting the parameters given in the 1 st Equation.
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Commercial Networks and File-sharing Networks: Competition or Complementarity?

Commercial Networks and File-sharing Networks: Competition or Complementarity?

networks. As such, they appear as ‘conformity costs’, whose levels are ex ante directly set by the moderators and indirectly shaped by the users of the peer-to-peer network who perceive a disutility if they do not behave as the moderators would like to (Cunningham, Alexander, & Adilov, 2004). Therefore, it is not relevant to present any file- sharing network as a distribution channel that gives free access to a wide range of digital goods (e.g., streams of digital files). Users have to bear costs to acquire digital files. Whether they are direct or indirect, the costs implied by the collection of digital files may be sufficiently high-leveled to motivate some internauts not to use file-sharing platforms and rather buy related official products. The commercial and non-commercial ways of acquiring cultural goods differ in the needs. Users may have to ‘rematerialize’ digital content for it to conveniently be used. From a more general point of view, they emphasize that there exist two different organizational models. The traditional – commercially based – organizational model is a model for which commercial players drive the production activity to influence consumption patterns, whereas the file-sharing model is a model in which moderators contribute to the costs needed to match the behaviors of the users to the initial expectations of the conceptors of the network.
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Automatic Detection of Attention Shifts in Infancy: Eye Tracking in the Fixation Shift Paradigm.

Automatic Detection of Attention Shifts in Infancy: Eye Tracking in the Fixation Shift Paradigm.

A remote eye-tracker (Tobii X120) was used to sample gaze-position at a rate of 60 Hz. This device, a free-standing unit containing near infrared light sources and cameras uses analysis of the position of the corneal reflections relative to the centre of the illuminated pupils to determine gaze positions of the subject [32]. The eye tracker was controlled via a Matlab pro- gram, which was used to extract gaze positions recorded by the eye tracker in real-time dur- ing testing. To determine online whether the subject was looking at a stimulus, the distance between the coordinates of the location of the gaze measured by the eye-tracker and the cen- tre of the screen was calculated. If the infant’s fixation was located within the screen coordi- nates after the infant-friendly movie was visible for a minimum of 3.3 seconds, the central stimulus appeared. The central stimulus remained visible for at least 2 seconds before the tar- get appeared, to avoid the infants becoming upset by the disappearance of the central stimu- lus as soon as they looked at it. If, after this period, fixation lay within the stimulus for more than 20 samples (0.33 seconds), this was considered a fixation on the stimulus which then triggered the onset of the peripheral target. The central stimulus either disappeared at the onset of the peripheral target (NC = non-competition condition) or remained visible for the duration of the peripheral target (C = competition). The peripheral target disappeared when the infants had fixated it (defined as a fixation within 8.8deg from the centre of the target) for at least 333 ms. S1 Text describes the MATLAB routine which was used to define a correct saccade and to filter out noisy data.
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Competition in cascades

Competition in cascades

Electricity production usually relies on natural resources such as water, oil, natural gas, sun- light, wind, and uranium. Di¤erent endowments of such resources lead countries to use di¤erent mixes of production technologies, which de…nes the power industry con…guration and structure. Despite these di¤erences, with slightly varying intensity across locations , the electricity industry is heavily regulated. Even countries that have undertaken broad liberalization reforms regulate their industries. Countries such as Brazil, Russia, China, India, and Venezuela, among others, with a large share of hydroelectric production, have centralized dispatch of generators. In some speci…c cases, like Brazil, Canada, and Norway, hydro-generation is the most important source of energy production. Indeed, in provinces such as British Columbia, Manitoba, and Quebec, more than 90% of the electricity comes from hydro-generation. The Nordpool market is characterized by the importance of hydroelectric generation, coming mostly from Norway, which competes with other technologies more prevalent in the other Nordic countries.
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International cooperation and competition policy

International cooperation and competition policy

The stages suggested are organized according to the degree of difficulty authorities face in undertaking cost/benefit analysis of the impact of competition measures on social welfare. However, it might well be the case that legally sound repression of price cartels turns out to be more difficult than the implementation of a merger review system. In fact, it is generally easy to assess the microeconomic impact of a cartel but it is hard to fulfill the requirements for an acceptable standard of proof for the courts. Therefore, the actual plan should take into account not only the difficulty in assessing the welfare impact of a particular antitrust illicit, but also the expected return on each dollar spent on the particular line of action, given the relative probabilities of success of alternative public policies.
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Poems

Poems

Paolo Totaro was born in Naples in 1933 and migrated to Sydney in 1963, where he joined the Australian Council as the irst Director of Community Arts. Among several other public positions, he was appointed Founding Chairman of the New South Wales Ethnic Afairs Commission, Visiting Professor of the University of Western Sydney and Pro-Chancellor at the University of Technology (UTS, Sydney). He has written poetry most of his life. Con- versazioni Mute was published in the anthology Two Hundred Years of Australian Poetry (OUP 1991), followed by Collected Poems 1950-2011 (Padana Press 2012).
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