Health care management autonomy: Evidence from the Catalonian hospital sector in a decentralised Spain

The organisation of inpatient care provision has undergone significant reform in many southern European countries. Overall across Europe, public management is moving towards the introduction of more flexibility and autonomy . In this setting, the promotion of the further decentralisation of health care provision stands out as a key salient policy option in all countries that have hitherto had a traditionally centralised structure. Yet, the success of the underlying incentives that decentralised structures create relies on the institutional design at the organisational level, especially in respect of achieving efficiency and promoting policy innovation without harming the essential principle of equal access for equal need that grounds National Health Systems (NHS). This paper explores some of the specific organisational developments of decentralisation structures drawing from the Spanish experience, and particularly those in the Catalonia. This experience provides some evidence of the extent to which organisation decentralisation structures that expand levels of autonomy and flexibility lead to organisational innovation while promoting activity and efficiency. In addition to this pure managerial decentralisation process, Spain is of particular interest as a result of the specific regional NHS decentralisation that started in the early 1980 s and was completed in 2002 when all seventeen autonomous communities that make up the country had responsibility for health care services.Already there is some evidence to suggest that this process of decentralisation has been accompanied by a degree of policy innovation and informal regional cooperation. Indeed, the Spanish experience is relevant because both institutional changes took place, namely managerial decentralisation leading to higher flexibility and autonomy- alongside an increasing political decentralisation at the regional level. The coincidence of both processes could potentially explain why some organisation and policy innovation resulting from policy experimentation at the regional level might be an additional featureto take into account when examining the benefits of decentralisation.

Environmental factors giving rise to variations in national management accounting practice

Comparative national management accounting is the least developed aspect in the field of international accounting. Only during the second half of the 1990's some comparisons of national managementaccounting practice have appeared published but only at theregional level. In this paper a range of factors that give rise to variations in national management accounting practice are postulated. We support this list with examples from a range of analyses of national management accounting practices, drawing particularly on the work of Lizcano (1996) and Bhimani (1996).Finally, twelve key factors are identified as influencing an individual country's approach to management accounting.

Generating global brand equity through corporate social responsibility to key stakeholders

In this paper we argue that corporate social responsibility (CSR) to various stakeholders(customers, shareholders, employees, suppliers, and community) has a positive effect on globalbrand equity (BE). In addition, policies aimed at satisfying community interests help reinforcecredibility to social responsible polices with other stakeholders. We test these theoreticalcontentions using panel data comprised of 57 global brands originating from 10 countries (USA,Japan, South Korea, France, UK, Italy, Germany, Finland, Switzerland and the Netherlands) forthe period 2002 to 2008. Our findings show that CSR to each of the stakeholder groups has apositive impact on global BE. In addition, global brands that follow local social responsibilitypolicies over communities obtain strong positive benefits in terms of the generation of BE, as itenhances the positive effects of CSR to other stakeholders, particularly to customers. Therefore,for managers of global brands it is particularly productive for generating brand value to combineglobal strategies with the satisfaction of the interests of local communities.

Auditing the management of vaccine-preventable disease outbreaks: the need for a tool

Public health activities, especially infectious disease control, depend on effective teamwork. We present the results of a pilot audit questionnaire aimed at assessing the quality of public health services in the management of VPD outbreaks. Audit questionnaire with three main areas indicators (structure, process and results) was developed. Guidelines were set and each indicator was assessed by three auditors. Differences in indicator scores according to median size of outbreaks were determined by ANOVA (significance at p (greater than or equal to) 0.05). Of 154 outbreaks; eighteen indicators had a satisfactory mean score, indicator "updated guidelines" and "timely reporting" had a poor mean score (2.84±106 and 2.44±1.67, respectively). Statistically significant differences were found according to outbreak size, in the indicators "availability of guidelines/protocol updated less than 3 years ago" (p = 0.03) and "days needed for outbreak control" (p = 0.04). Improving availability of updated guidelines, enhancing timely reporting and adequate recording of control procedures taken is needed to allow for management assessment and improvement.

A Secure and Anonymous Cooperative Sensing Protocol for Cognitive Radio Networks

Spectrum is an essential resource for the provision of mobile services. In order to control and delimit its use, governmental agencies set up regulatory policies. Unfortunately, such policies have led to a deficiency of spectrum as only few frequency bands are left unlicensed, and these are used for the majority of new emerging wireless applications. One promising way to alleviate the spectrum shortage problem is adopting a spectrum sharing paradigm in which frequency bands are used opportunistically. Cognitive radio is the key technology to enable this shift of paradigm.Cognitive radio networks are self-organized systems in which devices cooperate to use those spectrum ranges that are not occupied by licensed users. They carry out spectrum sensing in order to detect vacant channels that can be used for communication. Even though spectrum sensing is an active area of research, an important issue remains unsolved: the secure authentication of sensing reports. Not providing security enables the input of false data in the system thus empowering false results. This paper presents a distributed protocol based on wireless physical layer security, symmetric cryptography and one-way functions that allows determining a final sensing decision from multiple sources in a quick and secure way, as well as it preserves users¿ privacy.

Integration in strategic alliances : a conceptual framework of IT use in marketing as NPD key factor

En una economia basada en el coneixement, la innovació del producte es considera un factor clau a l'hora de determinar la competitivitat, la productivitat i el creixement d'una companyia. No obstant això, l'experiència de les companyies demostra la necessitat d'un nou model de gestió de la innovació del producte: una gestió basada en el màrqueting, en què la cooperació i l'ús intensiu de les tecnologies de la informació i de la comunicació (TIC) són especialment importants. En els darrers anys, la bibliografia sobre màrqueting ha analitzat el paper de la cooperació en l'èxit del procés d'innovació. No obstant això, fins ara pocs treballs han estudiat el paper que té l'ús de les TIC en el màrqueting en l'èxit del desenvolupament de nous productes (NPD, New Product Development en anglès). És una omissió curiosa, tenint en compte que el nou entorn competitiu és definit per una economia i una societat basades principalment en l'ús intensiu de les TIC i del coneixement. L'objectiu d'aquest treball és investigar el paper que l'ús de les TIC en el màrqueting té en el procés de desenvolupament de nous productes, com a element que reforça la integració d'agents al projecte, afavorint l'establiment de relacions dirigides a la cooperació i l'adquisició d'intel·ligència de mercat útil en el procés de desenvolupament de nous productes. L'estudi d'una mostra de 2.038 companyies de tots els sectors de l'activitat econòmica a Catalunya ens permet contrastar hipòtesis inicials i establir un perfil de companyia innovadora basat en les importants relacions que hi ha entre la innovació, l'ús de TIC en el màrqueting i la integració. Sobresurten dues idees en la nostra anàlisi. En primer lloc, l'ús intensiu de les TIC en el màrqueting fa que la companyia sigui més innovadora, ja que percep que el seu ús ajuda a superar barreres a la innovació i accelera els processos, que es tornen més eficients. En segon lloc, incrementant l'ús de les TIC en el màrqueting es fa augmentar la predisposició de la companyia a integrar agents particulars en l'entorn de negoci en el desenvolupament del procés d'innovació i a col·laborar-hi, de manera que es millora el grau d'adaptació del nou producte a les demandes del mercat.

Interoperability of learning objects copyright in the LUISA semantic learning management system

Semantic Web technology is able to provide the required computational semantics for interoperability of learning resources across different Learning Management Systems (LMS) and Learning Object Repositories (LOR). The EU research project LUISA (Learning Content Management System Using Innovative Semantic Web Services Architecture) addresses the development of a reference semantic architecture for the major challenges in the search, interchange and delivery of learning objects in a service-oriented context. One of the key issues, highlighted in this paper, is Digital Rights Management (DRM) interoperability. A Semantic Web approach to copyright management has been followed, which places a Copyright Ontology as the key component for interoperability among existing DRM systems and other licensing schemes like Creative Commons. Moreover, Semantic Web tools like reasoners, rule engines and semantic queries facilitate the implementation of an interoperable copyright management component in the LUISA architecture.

Considering tourist perceptions and network configuration in destination management

The competitiveness of tourism destinations is a relevant issue for tourism studies, moreso, is a key element on the daily basis of tourism destinations. In this sense, the management of tourism destinations is essential to maintain competitive advantages. In this article tourism destination is considered as a relational network, where interaction and cooperation is needed among tourist agents, to achieve major levels of competitive advantage and a more effective destination management system. In addition, the perceptions of tourists are obtained from two main sources. The first one is the social construction of a tourism destination previous to the visit and the second one is obtained from the interaction between tourists and tourism destination agents during the visit. In this sense, the management of tourism destination to emit a homogenous and collective image is a factor that can reduce the gap if dissatisfaction from the previous and real tourist perception. The discussion is centered on the relationship within a destination, between the supply network and the targeted demand, considering these two approaches jointly, to benefit destination management. The main result is a conceptual model that shows how tourism agents and tourists in the tourism destination interact to improve the destination competitiveness

Climate Change and the Cost of Carbon Sequestration: The Case of Forest Management

The Kyoto protocol allows Annex I countries to deduct carbon sequestered by land use, land-use change and forestry from their national carbon emissions. Thornley and Cannell (2000) demonstrated that the objectives of maximizing timber and carbon sequestration are not complementary. Based on this finding, this paper determines the optimal selective management regime taking into account the underlying biophysical and economic processes. The results show that the net benefits of carbon storage only compensate the decrease in net benefits of timber production once the carbon price has exceeded a certain threshold value. The sequestration costs are significantly lower than previous estimates