The comparative impact of privatisation and regulation on productivity growth in the English and Welsh water and sewerage industry, 1985-99

After the 10 regional water authorities of England and Wales were privatized in November 1989, the successor WASCs (water and sewerage companies) faced a new regulatory regime that was designed to promote productivity growth while simultaneously improving drinking water and environmental quality. As legally mandated quality improvements necessitated a costly capital investment programme, the industry's economic regulator – the Office of Water Services – implemented a RPI + K pricing system, designed to compensate the WASCs for their capital investment programme while also encouraging faster rates of productivity growth. This paper considers the relative effects of privatization and regulation on productivity growth in the industry using both non-parametric and parametric methods to provide a crosscheck on the robustness of the results. While there is evidence that labour productivity improved after privatization, there is no evidence that privatization led to a growth in TFP (total factor productivity). However, there is some evidence of a small increase in the rate of TFP growth in the aftermath of a substantial tightening of the regulatory regime that took place in 1995. These results, therefore, are consistent with evidence from other research that privatization, in the absence of effective competition and/or regulation, is not necessarily associated with improved economic performance.

The impact of leadership and quality climate on hospital performance

Objective. To explore the relationship between leadership effectiveness and health-care trust performance, taking into account external quality measures and the number of patient complaints; also, to examine the role of care quality climate as a mediator. Design. We developed scales for rating leadership effectiveness and care quality climate. We then drew upon UK national indices of health-care trust performance—Commission for Health Improvement star ratings, Clinical Governance Review ratings and the number of patient complaints per thousand. We conducted statistical analysis to examine any significant relationships between predictor and outcome variables. Setting. The study is based on 86 hospital trusts run by the National Health Service (NHS) in the UK. The data collection is part of an annual staff survey commissioned by the NHS to explore the quality of working life. Participants. A total of 17 949 employees were randomly surveyed (41% of the total sample). Results. Leadership effectiveness is associated with higher Clinical Governance Review ratings and Commission for Health Improvement star ratings for our sample (ß = 0.42, P < 0.05; ß = 0.37, P < 0.05, respectively), and lower patient complaints (ß = –0.57, P < 0.05). In addition, 98% of the relationship between leadership and patient complaints is explained by care quality climate. Conclusions. Results offer insight into how non-clinical leadership may foster performance outcomes for health-care organizations. A frequently neglected area—patient complaints—may be a valid measure to consider when assessing leadership and quality in a health-care context.

The impact of information and communication technology (ICT), education and regulation on economic freedom in Islamic Middle Eastern countries

Our study investigated the impact of ICT expansion on economic freedom in the Middle East (Bahrain, Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, United Arab Emirates, and Yemen). Our empirical analysis used archival data from 1995 to 2005; it showed that ICT expansion in the Middle East has been effective both in bridging the digital divide and also in promoting economic freedom in a region that was vulnerable to political, social, and global conflict. However, differences between countries, such as the educational attainment of their citizens and institutional resistance to technology acceptance, both enhanced and restricted the relationship between ICT and economic freedom.

Impact of senescence and disease on the structural and functional performance of the visual pathway

The diagnosis and monitoring of ocular disease presents considerable clinical difficulties for two main reasons i) the substantial physiological variation of anatomical structure of the visual pathway and ii) constraints due to technical limitations of diagnostic hardware. These are further confounded by difficulties in detecting early loss or change in visual function due to the masking of disease effects, for example, due to a high degree of redundancy in terms of nerve fibre number along the visual pathway. This thesis addresses these issues across three areas of study: 1. Factors influencing retinal thickness measures and their clinical interpretation As the retina is the principal anatomical site for damage associated with visual loss, objective measures of retinal thickness and retinal nerve fibre layer thickness are key to the detection of pathology. In this thesis the ability of optical coherence tomography (OCT) to provide repeatable and reproducible measures of retinal structure at the macula and optic nerve head is investigated. In addition, the normal physiological variations in retinal thickness and retinal nerve fibre layer thickness are explored. Principal findings were: • Macular retinal thickness and optic nerve head measurements are repeatable and reproducible for normal subjects and diseased eyes • Macular and retinal nerve fibre layer thickness around the optic nerve correlate negatively with axial length, suggesting that larger eyes have thinner retinae, potentially making them more susceptible to damage or disease • Foveola retinal thickness increases with age while retinal nerve fibre layer thickness around the optic nerve head decreases with age. Such findings should be considered during examination of the eye with suspect pathology or in long-term disease monitoring 2. Impact of glucose control on retinal anatomy and function in diabetes Diabetes is a major health concern in the UK and worldwide and diabetic retinopathy is a major cause of blindness in the working population. Objective, quantitative measurements of retinal thickness. particularly at the macula provide essential information regarding disease progression and the efficacy of treatment. Functional vision loss in diabetic patients is commonly observed in clinical and experimental studies and is thought to be affected by blood glucose levels. In the first study of its kind, the short term impact of fluctuations in blood glucose levels on retinal structure and function over a 12 hour period in patients with diabetes are investigated. Principal findings were: • Acute fluctuations in blood glucose levels are greater in diabetic patients than normal subjects • The fluctuations in blood glucose levels impact contrast sensitivity scores. SWAP visual fields, intraocular pressure and diastolic pressure. This effect is similar for type 1 and type 2 diabetic patients despite the differences in their physiological status. • Long-term metabolic control in the diabetic patient is a useful predictor in the fluctuation of contrast sensitivity scores. • Large fluctuations in blood glucose levels and/or visual function and structure may be indicative of an increased risk of development or progression of retinopathy 3. Structural and functional damage of the visual pathway in glaucomatous optic neuropathy The glaucomatous eye undergoes a number of well documented pathological changes including retinal nerve fibre loss and optic nerve head damage which is correlated with loss of functional vision. In experimental glaucoma there is evidence that glaucomatous damage extends from retinal ganglion cells in the eye, along the visual pathway, to vision centres in the brain. This thesis explores the effects of glaucoma on retinal nerve fibre layer thickness, ocular anterior anatomy and cortical structure, and its correlates with visual function in humans. Principal findings were: • In the retina, glaucomatous retinal nerve fibre layer loss is less marked with increasing distance from the optic nerve head, suggesting that RNFL examination at a greater distance than traditionally employed may provide invaluable early indicators of glaucomatous damage • Neuroretinal rim area and retrobulbar optic nerve diameter are strong indicators of visual field loss • Grey matter density decreases at a rate of 3.85% per decade. There was no clear evidence of a disease effect • Cortical activation as measured by fMRI was a strong indicator of functional damage in patients with significant neuroretinal rim loss despite relatively modest visual field defects These investigations have shown that the effects of senescence are evident in both the anterior and posterior visual pathway. A variety of anatomical and functional diagnostic protocols for the investigation of damage to the visual pathway in ocular disease are required to maximise understanding of the disease processes and thereby optimising patient care.

The impact of transactional and relational strategies in business markets:an agenda for inquiry

The impetus for the special issue of Industrial Marketing Management is the importance of understanding the implications of transactional and relational strategies in business-to-business contexts. The objective of the special issue is to integrate conceptual and empirical research in this area. We highlight research that extends current thinking in the area to ensure that this special issue serves an impetus for future research on this important topic.

The impact of stressors and regulatory focus on creativity:a dual level of analysis

Presentation

The impact of privatisation and regulation on the water and sewerage industry in England and Wales:a translog cost function approach

After the ten Regional Water Authorities (RWAs) of England and Wales were privatized in November 1989, the successor Water and Sewerage Companies (WASCs) faced a new regulatory regime that was designed to promote economic efficiency while simultaneously improving drinking water and environmental quality. As legally mandated quality improvements necessitated a costly capital investment programme, the industry's economic regulator, the Office of Water Services (Ofwat), implemented a retail price index (RPI)+K pricing system, which was designed to compensate the WASCs for their capital investment programme while also encouraging gains in economic efficiency. In order to analyse jointly the impact of privatization, as well as the impact of increasingly stringent economic and environmental regulation on the WASCs' economic performance, this paper estimates a translog multiple output cost function model for the period 1985–1999. Given the significant costs associated with water quality improvements, the model is augmented to include the impact of drinking water quality and environmental quality on total costs. The model is then employed to determine the extent of scale and scope economies in the water and sewerage industry, as well as the impact of privatization and economic regulation on economic efficiency.

Shared cognitive processes underlying past and future thinking:the impact of imagery and concurrent task demands on event specificity

Recent literature has argued that whereas remembering the past and imagining the future make use of shared cognitive substrates, simulating future events places heavier demands on executive resources. These propositions were explored in 3 experiments comparing the impact of imagery and concurrent task demands on speed and accuracy of past event retrieval and future event simulation. Results provide support for the suggestion that both past and future episodes can be constructed through 2 mechanisms: a noneffortful "direct" pathway and a controlled, effortful "generative" pathway. However, limited evidence emerged for the suggestion that simulating of future, compared with retrieving past, episodes places heavier demands on executive resources; only under certain conditions did it emerge as a more error prone and lengthier process. The findings are discussed in terms of how retrieval and simulation make use of the same cognitive substrates in subtly different ways. © 2011 American Psychological Association.

Consumers’ biased perceptions of the environmental impact of products, and their influence on advertising efficiency

This paper investigates the main perceptual biases developed by consumers regarding the environmental impact of products. It shows that these biases make consumers unable to distinguish between advertisements for highly versus less sustainable products, but that the inclusion of relevant information can increase the efficiency of arguments for true sustainability.

The impact of ageing and gender on visual mental imagery processes:a study of performance on tasks from the Complete Visual Mental Imagery Battery (CVMIB)

In this study we aim to evaluate the impact of ageing and gender on different visual mental imagery processes. Two hundred and fifty-one participants (130 women and 121 men; age range = 18–77 years) were given an extensive neuropsychological battery including tasks probing the generation, maintenance, inspection, and transformation of visual mental images (Complete Visual Mental Imagery Battery, CVMIB). Our results show that all mental imagery processes with the exception of the maintenance are affected by ageing, suggesting that other deficits, such as working memory deficits, could account for this effect. However, the analysis of the transformation process, investigated in terms of mental rotation and mental folding skills, shows a steeper decline in mental rotation, suggesting that age could affect rigid transformations of objects and spare non-rigid transformations. Our study also adds to previous ones in showing gender differences favoring men across the lifespan in the transformation process, and, interestingly, it shows a steeper decline in men than in women in inspecting mental images, which could partially account for the mixed results about the effect of ageing on this specific process. We also discuss the possibility to introduce the CVMIB in clinical assessment in the context of theoretical models of mental imagery.

Impact of severity and type of depression on quality of life in cases identified in the community

BACKGROUND: The impact of different levels of depression severity on quality of life (QoL) is not well studied, particularly regarding ICD-10 criteria. The ICD classification of depressive episodes in three levels of severity is also controversial and the less severe category, mild, has been considered as unnecessary and not clearly distinguishable from non-clinical states. The present work aimed to test the relationship between depression severity according to ICD-10 criteria and several dimensions of functioning as assessed by Medical Outcome Study (MOS) 36-item Short Form general health survey (SF-36) at the population level. METHOD: A sample of 551 participants from the second phase of the Outcome of Depression International Network (ODIN) study (228 controls without depression and 313 persons fulfilling ICD criteria for depressive episode) was selected for a further assessment of several variables, including QoL related to physical and mental health as measured with the SF-36. RESULTS: Statistically significant differences between controls and the depression group were found in both physical and mental markers of health, regardless of the level of depression severity; however, there were very few differences in QoL between levels of depression as defined by ICD-10. Regardless of the presence of depression, disability, widowed status, being a woman and older age were associated with worse QoL in a structural equation analysis with covariates. Likewise, there were no differences according to the type of depression (single-episode versus recurrent). CONCLUSIONS: These results cast doubt on the adequacy of the current ICD classification of depression in three levels of severity.