A planning model for needs analysis for subacute care

The purpose of this study is to produce a model to be used by state regulating agencies to assess demand for subacute care. In accomplishing this goal, the study refines the definition of subacute care, demonstrates a method for bed need assessment, and measures the effectiveness of this new level of care. This was the largest study of subacute care to date. Research focused on 19 subacute units in 16 states, each of which provides high-intensity rehabilitative and/or restorative care carried out in a high-tech unit. Each of the facilities was based in a nursing home, but utilized separate staff, equipment, and services. Because these facilities are under local control, it was possible to study regional differences in subacute care demand.^ Using this data, a model for predicting demand for subacute care services was created, building on earlier models submitted by John Whitman for the American Hospital Association and Robin E. MacStravic. The Broderick model uses the "bootstrapping" method and takes advantage of high technology: computers and software, databases in business and government, publicly available databases from providers or commercial vendors, professional organizations, and other information sources. Using newly available sources of information, this new model addresses the problems and needs of health care planners as they approach the challenges of the 21st century. ^

Profile of planning: A study of a three-year project on the implementation of collaborative library media programs

The implementation of collaborative planning and teaching models in ten flexibly scheduled elementary and middle school library media centers was studied to determine which factors facilitated the collaborative planning process and to learn what occurs when library media specialists (LMSs) and classroom teachers (CTs) plan together. In this qualitative study, 61 principals, CTs, and LMSs were interviewed on a range of topics including the principal's role, school climate, the value of team planning, the importance of information literacy instruction, and the ideal learning environment. Other data sources were observations, videotapes of planning sessions, and documents. This three-year school reform effort was funded by the Library Power Project to improve library programs, to encourage collaborative planning, and to increase curricular integration of information literacy skills instruction. ^ The findings included a description of typical planning sessions and the identification of several major factors which impacted the success of collaborative planning: the individuals involved, school climate, time for planning, the organization of the school, the facility and collection, and training. Of these factors, the characteristics and actions of the people involved were most critical to the implementation of the innovation. The LMS was the pivotal player and, in the views of CTs, principals, and LMSs themselves, must be knowledgeable about curriculum, the library collection, and instructional design and delivery; must be open and welcoming to CTs and use good interpersonal skills; and must be committed to information literacy instruction and willing to act as a change agent. The support of the principal was vital; in schools with successful programs, the principal served as an advocate for collaborative planning and information literacy instruction, provided financial support for the library program including clerical staff, and arranged for LMSs and CTs to have time during the school day to plan together. ^ CTs involved in positive planning partnerships with LMSs were flexible, were open to change, used a variety of instructional materials, expected students to be actively involved in their own learning, and were willing to team teach with LMSs. Most CTs planning with LMSs made lesson plans in advance and preferred to plan with others. Also, most CTs in this study planned with grade level or departmental groups, which expedited the delivery of information literacy instruction and the effective use of planning time. ^ Implications of the findings of this research project were discussed for individual schools, for school districts, and for colleges and universities training LMSs, CTs, and administrators. Suggestions for additional research were also included. ^

Organizational culture, organizational climate, and collaborative capacity for planning

The objective of this study was to investigate the relationship of organizational culture and organizational climate on participant perceptions of collaborative capacity for planning, within the context of the Florida School Readiness Coalitions (FSRCs). Three hypotheses were proposed for study: First, that organizational culture would be correlated to organizational climate; second, that organizational culture would be correlated to collaborative capacity for planning; and the third that organizational climate would be correlated to collaborative capacity for planning. ^ A cross-sectional survey research design was used to obtain data from participants in 25 Florida School Readiness Coalitions. Pearson product-moment correlations were used to examine the association between the dependent variable, collaborative capacity for planning, and the independent variables, organizational culture and climate. Bivariate analyses revealed a significant level of association for five culture indicators to collaborative capacity for planning: motivation, interpersonal, service, supportive and individualistic indicators, and four climate indicators: cooperation, job satisfaction, organizational commitment, and role clarity. Findings suggest (a) a constructive culture and positive climate were present within the FSRCs during the period of study and (b) participants perceived that the collaborative capacity for planning existed. Hierarchical multiple regression, controlling for effects of participant demographics, were used to examine the degree to which organizational culture and climate predict collaborative capacity. The culture indicators, supportive and individualistic, and the climate indicator job satisfaction accounted for 46% of the variance in collaborative capacity for planning. No other indicators of the independent variables demonstrated significance. The findings suggests that (a) culture and climate should be studied together, (b) culture and climate are two constructs that may provide knowledge about the way community groups work together, and (c) the collaborative capacity of groups planning services such as the FSRCs may benefit through consideration of how culture and climate affect service planners' relationships, communication, and ability to achieve a mission or goal. Culture and climate may offer social workers new information about internal factors affecting the collaborative process. Further investigation of these constructs with other types of groups is warranted. ^

Industry Expresses Attitudes Toward Accounting, Finance Curricula

A survey of hospitality financial executives provides guidance for those planning accounting and finance curricula for schools of hospitality management. The authors discuss the results of their survey sponsored by the Association of Hospitality Financial Management Educators.

A planning model for needs analysis for subacute care

The purpose of this study is to produce a model to be used by state regulating agencies to assess demand for subacute care. In accomplishing this goal, the study refines the definition of subacute care, demonstrates a method for bed need assessment, and measures the effectiveness of this new level of care. This was the largest study of subacute care to date. Research focused on 19 subacute units in 16 states, each of which provides high-intensity rehabilitative and/or restorative care carried out in a high-tech unit. Each of the facilities was based in a nursing home, but utilized separate staff, equipment, and services. Because these facilities are under local control, it was possible to study regional differences in subacute care demand. Using this data, a model for predicting demand for subacute care services was created, building on earlier models submitted by John Whitman for the American Hospital Association and Robin E. MacStravic. The Broderick model uses the "bootstrapping" method and takes advantage of high technology: computers and software, databases in business and government, publicly available databases from providers or commercial vendors, professional organizations, and other information sources. Using newly available sources of information, this new model addresses the problems and needs of health care planners as they approach the challenges of the 21st century.

The Affordable Care Act and the Transformation of US Health Care

The neoliberal period was accompanied by a momentous transformation within the US health care system.  As the result of a number of political and historical dynamics, the healthcare law signed by President Barack Obama in 2010 ‑the Affordable Care Act (ACA)‑ drew less on universal models from abroad than it did on earlier conservative healthcare reform proposals. This was in part the result of the influence of powerful corporate healthcare interests. While the ACA expands healthcare coverage, it does so incompletely and unevenly, with persistent uninsurance and disparities in access based on insurance status. Additionally, the law accommodates an overall shift towards a consumerist model of care characterized by high cost sharing at time of use. Finally, the law encourages the further consolidation of the healthcare sector, for instance into units named “Accountable Care Organizations” that closely resemble the health maintenance organizations favored by managed care advocates. The overall effect has been to maintain a fragmented system that is neither equitable nor efficient. A single payer universal system would, in contrast, help transform healthcare into a social right.

El impacto de la crisis en la industria cinematográfica en Europa

Este trabajo analiza el impacto que ha generado la crisis económica y financiera más reciente en las industrias cinematográficas de siete países miembros de la Unión Europea. Las conclusiones señalan que, en efecto, la crisis ha impactado negativamente en las industrias de España e Italia, y muy gravemente en la de Portugal, pero en el lado contrario, la del Reino Unido ha experimentado un crecimiento apreciable y las de Francia y Alemania también lo han hecho, aunque en menor medida. Y en segundo lugar, es muy notable la escasa colaboración alcanzada entre los agentes europeos.

Building public policy on shifting sands: the case of the National Asset Management Agency

Over the last thirty years, there has been an increased demand for better management of public sector organisations (PSOs). This requires that they are answerable for the inputs that they are given but also for what they achieve with these inputs (Hood 1991; Hood 1995). It is suggested that this will improve the management of the organisation through better planning and control, and the achievement of greater accountability (Smith 1995). However, such a rational approach with clear goals and the means to measure achievement can cause difficulties for many PSOs. These difficulties include the distinctive nature of the public sector due to the political environment within which the public sector manager operates (Stewart and Walsh 1992) and the fact that PSOs will have many stakeholders, each of whom will have their own specific objectives based on their own perspective (Boyle 1995). This can
result in goal ambiguity which means that there is leeway in interpreting the results of the PSO. The National Asset Management Agency (NAMA) was set up to bring stability to the financial system by buying loans from the banks (which were in most cases, non-performing loans). The intention was to cleanse the banks of these loans so that they could return to their normal business of taking deposits and making loans. However, the legislation, also gave NAMA a wide range of other responsibilities including responsibility for facilitating credit in the economy and protecting the interests of taxpayers. In more recent times, NAMA has been given responsibility for building social housing. This wide-range of activities is a clear example of a PSO being given multiple goals which may conflict and is therefore likely to lead to goal ambiguity. This makes it very difficult to evaluate NAMA’s performance as they are attempting to meet numerous goals at the same time and also highlights the complexity of policy making in the public sector. The purpose of this paper is to examine how NAMA dealt with goal ambiguity. This will be done through a thematic analysis of its annual reports over the last five years. The paper’s will contribute to the ongoing debate about the evaluation of PSOs and the complex environment within which they operate which makes evaluation difficult as they are
answerable to multiple stakeholders who have different objectives and different criteria for measuring success.

Financial literacy and over-indebtedness in low-income households

Financial literacy can explain a significant proportion of wealth inequality. Among the key components of financial literacy are numeracy and money management skills. Our study examines the relative importance of these components in the determination of consumer debt and household net worth among credit union members in socially disadvantaged areas. The main finding from our analysis is that money management skills are important determinants of financial outcomes but that numeracy has almost no role to play. This result adds to a recent US-based behavioural finance literature on the role of attention and planning in consumer finance. Findings are found to be robust when the sample is reduced to only those who have a clear role in household financial decision-making and also when controlling for potential endogeneity. Our findings have policy implications in the UK and elsewhere as credit unions across the world are important players in national financial literacy strategies.

Rede Social Pessoal de Cuidadores Informais de Adultos com Necessidades Especiais

Objetivo. Devido ao aumento da esperança de vida, os adultos com necessidades especiais vivem mais tempo, sendo os seus principais cuidadores, geralmente familiares, também mais envelhecidos. Tal situação representa novas necessidades específicas de apoio, sendo inúmeros os desafios colocados ao Serviço Social no sentido de garantir o bem-estar da pessoa com incapacidade e dos seus cuidadores. Assim, este estudo tem como objetivo realizar um levantamento das necessidades de apoio e a caraterização da rede social pessoal de apoio do cuidador informal de adultos com necessidades especiais. Participantes. A amostra é constituída por 40 cuidadores informais de adultos com necessidades especiais, integrados na resposta social “Centro de Atividades Ocupacionais-CAO” da Associação de Paralisia Cerebral de Coimbra, de ambos os sexos com idade igual ou superior a 40 anos. Material e métodos. Foi utilizado o Instrumento de Avaliação da Rede Social Pessoal e um questionário para caracterização sociodemográfica e sociofamiliar dos cuidadores, assim como para avaliação de necessidades. Resultados. Aproximadamente um terço dos cuidadores relatou a experiência de níveis moderados de sobrecarga associada à prestação de cuidados, enquanto mais de metade relatou a experiência de níveis elevados e muito elevados dessa sobrecarga; o apoio financeiro foi referido como a forma de apoio mais necessária no presente, ainda que o apoio em residência tenha sido percecionado por cerca de um terço dos cuidadores como a forma de apoio mais necessária no futuro; enquanto mais de metade considerou o apoio domiciliário e de unidade residencial (institucional). Estes cuidadores familiares referiram a "incerteza" e a "esperança" como os sentimentos mais frequentemente experienciados em relação ao futuro das suas vidas. No que respeita às redes sociais, as relações familiares são centrais a nível estrutural; em termos de caraterísticas funcionais da rede, foram observados valores mais elevados para as dimensões de reciprocidade do apoio e satisfação com a rede social. Implicações. Este estudo sublinha a importância da avaliação das necessidades de apoio dos cuidadores familiares de adultos com necessidades especiais. A sua implementação sistemática pode auxiliar a tomada de decisão baseada na evidência empírica para as intervenções do Serviço Social, tais como na planificação e gestão de respostas e serviços sociais, a par do reconhecimento e ativação dos recursos das próprias famílias, de forma a promover a eficiência dos recursos e eficácia das intervenções, focadas no bem-estar do cidadão com deficiência e das suas famílias. / Aim. The general increase in human life expectancy has resulted in greater rates of survival for adults with special care needs, as well as for their ageing family caregivers. This situation poses different and specific support needs, which represent a major challenge in social work interventions aimed at ensuring the well-being of disabled persons and their caregivers. Therefore, this study was aimed to describe the needs for support and the perceived social support network of family caregivers of adults with special care needs. Participants. The sample for this study comprised 40 family caregivers of disabled adults with special care needs, of both genders and aged 40 years old at minimum, who attended a long-term care facility at Coimbra Cerebral Palsy Association. Material and methods. Participants were administered a self-report questionnaire on socio-economic, family and caregiving needs, along with the Instrument for Assessing Personal Social Networks. Results. Nearly one third a family caregivers experienced moderate caregiving burden, while more than half experienced high or very high levels of caregiving burden; financial support was perceived as the most needed form of support in the present, but residential home care was identified as the most needed form of support in the future; while more than a half considered home-based support and residential support viable options for their disabled family members with special care needs. These family caregivers reported "uncertainty" and "hope" as the most common feelings towards their family life in the future. On the topic of social networks, family relations were found to be crucial at the structural level; in terms of functional characteristics of the network, elevated scores were observed for reciprocity of support and satisfaction with the social network. Implications. This study highlights the importance of increasing the specificity of the assessments of needs for support in family caregivers of disabled adults with special care needs. The systematic conduction of these assessments may assist evidence-based decision making in social work interventions, such as for planning and managing social services, acknowledging and activating the families' own resources, and ultimately promote the efficacy and effectiveness 57 interventions aimed at improving the well-being of disabled citizens and their families.

The Proposed Financial Transaction Tax – Extraterritorial Effect, Tax Evasion and Other Legal Problems Facing the Proposal

The main topic of this master’s thesis is the proposed EU directive on a financial transaction tax. Ten Member States which want to enact the directive by using enhanced cooperation are currently negotiating the contents of the proposal. This tax would be levied on specific products which are traded on the financial markets. As an example the transaction of stocks would be taxed at a percentage of 0.1 percent, and the transaction of derivatives at a percentage of 0.01 percent. The proposed financial transaction tax would enter into force in said ten countries but it would still have effects on those countries, which are not planning on participating in this taxation system. This is one of the main reasons why this tax has faced a lot of opposition in several European Union countries. The main legal problems the tax is predicted to have are tax evasion, double taxation, and extraterritorial effect. The Commission has stated that it is aiming to reach certain objectives with the financial transaction tax. These objectives are for example to stabilise the financial markets following the financial crisis, and to deter tax evasion. Commission has defended the planning of the financial transaction tax by stating that the tax is likely to reach its objectives. The planning of the financial transaction tax began already in 2011 when the Commission published the first draft of the proposal. Following this the proposal was last amended in 2013, but the participating Member States are currently still negotiating the contents of the proposal. The participating Member States published a statement in December 2015 in which they promised that there will be a decision made about the financial transaction tax by the end of June 2016.

RARβ gene methylation is a candidate for primary glioblastoma treatment planning.

Background: We screened RARβ methylation in primary glioblastoma multiforme (GBM) and the results were evaluated based on the clinical data and treatment type. Objective: The objective of this study was to find new areas for the usage of MS-HRM applications in the determination of methylation levels in primary GBM samples and it shows the association of RARβ methylation with the clinical outcome. Methods: In our study, tumor samples were collected during surgical resection by the Department of Neurosurgery. The clinical and radiologic data was carefully reviewed, compared, and evaluated with the histological results. The methylation status of RARβ was determined by using MS-HRM. Results: RARβ gene methylation was detected in 24 out of 40 cases (60%), with different quantitative methylation levels. The mean survival time was 19 months form ethylated cases and 15 months for the non-methylated cases. The survival time of the patients who received treatment was 25 months and the survival time of the patients who received radiotherapy alone or where no treatment protocol applied was 15-20 months. Therefore, a significant difference in survival rates has been observed (P<0.05). This study indicates a potential prognostic value for GBM treatment planning. Conclusion: Our study is the first study to investigate RARβ methylation in primary GBMs. We conclude that the RARβ gene could be a new prognostic and predictive candidate marker to designate the treatment protocol for primary GBMs. Keywords:

Health spending, illicit financial flows and tax incentives in Malawi

This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax revenues foregone by the government of Malawi by two main routes • Illicit financial flows (IFF) from the country • Tax incentives. We find that there are significant financing gaps in the health sector; for example, government expenditure is United States Dollars (USD) 177 million for 2013/2014 while projected donor contribution in 2013/2014 is USD 207 million and the total cost for the minimal health package is USD 535 million. Thus the funding gap between the government budget for health and the required spending to provide the minimal package for 2013/2014 is USD 358 million. On the other hand we estimate that almost USD 400million is lost through IFF and corporate utilization of tax incentives each year. The revenues foregone plus the current government health spending would be sufficient to cover the minimal public health package for all Malawians and would help tackle Malawi’s disease burden. Every effort must be made, including improving transparency and revising laws, to curtail IFF and moderate tax incentives.

Role of financial and other information in trade credit decisions in SMEs: An international study

Trade credit is an important source of finance for SMEs and this study investigates the use of the financial statements and other information in making trade credit decisions in smaller entities in Finland, the UK, USA and South Africa. The study adds to the literature by examining the information needs of unincorporated entities as a basis for making comparisons with small, unlisted companies. In-depth, semi-structured interviews in each country were used to collect data from the owner-managers of SMEs and from credit rating agencies and credit insurers. The findings provide insights into similarities and differences between countries and between developed and developing economies. The evidence suggests that there are three main influences on the trade credit decision: formal and report-based information, soft information relating to social capital and contingency factors. The latter dictate the extent to which hard/formal information versus soft/informal information is used.

Three essays on corporate taxation : financial reporting, value, and firm creation

Doutoramento em Gestão