Horizontal innovation in the theory of growth and development

We analyze recent contributions to growth theory based on the model of expanding variety of Romer (1990). In the first part, we present different versions of the benchmark linear model with imperfect competition. These include the labequipment model, labor-for-intermediates and directed technical change . We review applications of the expanding variety framework to the analysis of international technology diffusion, trade, cross-country productivity differences, financial development and fluctuations. In many such applications, a key role is played by complementarities in the process of innovation.

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.

Asessing public policies. The case of education in Europe and the interaction between personal and institutional factors

The paper deals with the comparative study of European citizens satisfaction with thestate of education in their respective countries. Individual and contextual effects aretested applying multilevel analysis. The results show that educational public policies(level of decentralization, degree of comprehensiveness and public spending) as well asthe students social environment (socioeconomic and cultural status) have a soundimpact on the opinions about the state of education.

Concepções, Práxis e Tendências de Desenvolvimento Curricular no Ensino Superior Público em Cabo Verde: um Estudo de Caso Sobre a Universidade de Cabo Verde

A tese enquadra-se nas discussões sobre as concepções do currículo, como problemática central nos processos de educação e formação, e o papel da Universidade ao longo dos tempos, mormente nos contextos actuais da globalização, conferindo especial relevo às concepções, práxis e tendências que caracterizam a experiência de desenvolvimento curricular na Universidade de Cabo Verde (Uni-CV), desde a sua criação, em Novembro de 2006, no seguimento de um percurso de quase três décadas do ensino superior público cabo-verdiano Com o enquadramento teórico da problemática da investigação faz-se uma ampla cartografia da literatura relevante no campo científico dos estudos curriculares, numa abordagem que patenteia a diversidade de conceptualizações do currículo e do desenvolvimento curricular, os principais traços característicos das teorias curriculares que se têm sucedido e ou que rivalizam na busca de hegemonia no sector da educação, bem como as políticas educativas e curriculares que vêm sendo concebidas e realizadas à escala global, dispensando atenção particular às dimensões instituinte e instituída do processo curricular. Ainda que fortemente condicionado pelas concepções e políticas de globalização da educação, a tendência para a uniformização educativa e curricular não constitui uma inevitabilidade, demonstrando-se, pelo contrário, que o processo de desenvolvimento curricular deixa espaços de apropriação e inovação ao nível das instituições educativas, atendendo à diversidade de contextos, expectativas e perspectivas inerentes à dinâmica da realização do currículo. Ainda no plano teórico, ao analisar-se a evolução do conceito ou ideia de Universidade, desde a sua génese até aos tempos actuais, coloca-se em relevo a natureza específica da instituição no âmbito do ensino superior, patenteando o modo como, nos diferentes contextos, a mesma tem procurado afirmar a centralidade do conhecimento e do currículo no cumprimento da sua missão, a despeito de factores e condicionalismos diversos, de entre os quais releva o tipo de relacionamento predominante entre a Universidade, o Estado e o mercado, no âmbito do qual se deve entender a complexidade da crise institucional, na triplicidade das suas manifestações (crise de legitimidade, de hegemonia e de identidade) que atravessa a academia, com reflexos ao nível das tendências para o condicionamento da autonomia, missão e funções da academia, assim como da própria natureza do conhecimento universitário. Na procura de saídas para a crise, que é global e, como tal, se reflecte nas universidades do continente africano, em que se insere Cabo Verde, a Universidade é desafiada a afirmar a sua especificidade institucional, enquanto promotora da alta cultura e da capacidade de pensamento de longo prazo, conciliando, deste modo, as suas funções essenciais ou simbólicas com as que se prendem com a satisfação das necessidades imediatas ou de curto prazo da economia e do mercado. Com base nos pertinentes subsídios teóricos, os estudos empíricos desenvolvem-se segundo a abordagem metodológica de estudo de caso, em que a análise documental e as técnicas de investigação qualitativa e quantitativa permitiram consolidar as evidências sobre: (i) os antecedentes da criação da Uni-CV, através do mapeamento do percurso académico e curricular dos diversos estabelecimentos públicos de ensino superior que precederam a universidade pública, legando a esta o seu património científico, tecnológico e logístico, com as inerentes potencialidades e limitações; (ii) o processo de institucionalização da Uni-CV, com a referencialização das opções estruturantes da organização e gestão da Universidade assim como da política educativa e curricular da Universidade; (iii) a experiência multifacetada de desenvolvimento curricular na novel instituição durante os cinco primeiros anos de funcionamento (2006-2011), correlacionando opções e práxis e evidenciando tendências da sua evolução. Da análise interpretativa dos estudos empíricos realizados, mediante a triangulação dos dados de arquivo e de perspectiva, resulta que a Uni-CV, não obstante as fragilidades persistentes no processo de seu desenvolvimento institucional, tem cumprido a sua missão de forma satisfatória, facto que fica a dever-se quer à adequação das opções, normas e directivas conformadoras da dimensão instituinte do processo curricular, quer ao esforço de realização das prescrições curriculares, sendo, todavia, evidentes os desafios a serem vencidos tendo em vista a consecução da almejada excelência académica, que os Estatutos propugnam, e que passa, nomeadamente, pela melhoria do nível da qualificação do seu corpo docente, pela implementação ou funcionamento efectivo de alguns dos órgãos da academia e pela afirmação da investigação científica como função incontornável para o desempenho cabal das funções de ensino e extensão. De entre as conclusões, sustenta-se que, no processo de integração de Cabo Verde nas redes internacionais de investigação e excelência científica e tecnológica, como, de resto, propugnam os Estatutos da Uni-CV, deve atender-se à especificidade deste pequeno país do Atlântico Médio, tendo em conta as suas fragilidades estruturais, pelo que se impõe algum distanciamento crítico em relação à incorporação de certas opções de política educativa e curricular que emanam de instâncias internacionais, independentemente do seu carácter inovador ou mesmo da sua possível consistência científica e técnica, comprovada em outros contextos.

Drug innovation, prices and health

This article tries to reconcile economic-industrial policy with health policy when dealing with biomedical innovation and welfare state sustainability. Better health accounts for an increasingly large proportion of welfare improvements. Explanation is given to the welfare losses coming from the fact than industrial and health policy tend to ignore each other. Drug s prices reflecting their relative relative effectiveness send the right signal to the industry rewarding innovation with impact on quantity and quality of life- and to the buyers of health care services.The level of drug s public reimbursement indicates the social willingness to pay of the different national health systems, not only by means of inclusion, or rejection, in the basket of services covered, but especially establishing the proportion of the price that is going to be financed publicly.Reference pricing for therapeutic equivalents as the upper limit of the social willingness to pay- and two-tiered co-payments for users (avoidable and inversely related with the incremental effectiveness of de drug) are deemed appropriate for those countries concerned at the same time with increasing their productivity and maintaining its welfare state. Profits drive R&D but not its location. There is no intrinsic contradiction between high productivity and a consolidated National Health Service (welfare state) as the European Nordic Countries are telling us every day.

Lobbying, innovation and protectionist cycles

This paper explains why trade liberalizations occur in developing countries,and why they are often reversed. It does so by focusing on the use oflobbying for protection by import competing firms as a means to postponecostly product quality upgrades to keep up with foreign competitors. Giventhe availability of a political market for import tariffs, domestic firmswill lobby for a sequence of tariffs that insulate domestic profits from awidening quality gap, thereby allowing adjustment to be postponed. But asthe contributions required by the government grow with the size of thequality gap, it will be optimal to adjust quality and to decrease thelobbying effort at some time, leading to liberalization and technologicalcatch-up. But then the equilibrium tariff will again be small and "cheap",and it will pay to start lobbying anew, until the next quality adjustment.Therefore, cycles in protection will occur as a result of the use oflobbying as a substitute for innovation. The model thus sheds new light onthe impact of the costs of protection on the effectiveness of the lobbyingeffort over time, and on their implications for the timing and the timehorizon of trade reforms in developing countries.

Institutional support of the firm: A theory of business registries

Registering originative business contracts allows entrepreneurs and creditors to choose, andcourts to enforce market-friendly contract rules that protect innocent third parties whenadjudicating disputes on subsequent contracts. This reduces information asymmetry for thirdparties, which enhances impersonal trade. It does so without seriously weakening property rights,because it is rightholders who choose or activate the legal rules and can, therefore, minimize thecost of any possible weakening. Registries are essential not only to make the chosen rules publicbut to ensure rightholders commitment and avoid rule-gaming, because independent registriesmake rightholders choices verifiable by courts. The theory is supported by comparative andhistorical analyses.

Entrepreneurial risk, investment and innovation

In this paper I develop a general equilibrium model with risk averse entrepreneurialfirms and with public firms. The model predicts that an increase in uncertainty reducesthe propensity of entrepreneurial firms to innovate, while it does not affect thepropensity of public firms to innovate. Furthermore, it predicts that the negativeeffect of uncertainty on innovation is stronger for the less diversified entrepreneurialfirms, and is stronger in the absence of financing frictions in the economy. In thesecond part of the paper I test these predictions on a dataset of small and mediumItalian manufacturing firms.

Organisational innovations and health care decentralisation: A perspective from Spain

Recent policy developments in public health care systems lead to a greater diversity in health care. Decentralisation, either geographically or at an institutional level, is the key force, because it encourages innovation and local initiatives in health care provision. The devolution of responsibilities allows for a sort of de-construction of the status quo by changing both organizational forms and service provision. The new organizations enjoy greater freedom in the way they pay their staff, and are judged according to their results. These organizations may retain financial surpluses, develop spin-off companies and commission a range of specialised services (such as Diagnostic and Treatment Centres in UK) from providers outside the institutional setting in order to have more access to capital markets. However this diversity may generate a feeling of lack of commitment to a national health service and ultimately a loss of social cohesion. By fiscal decentralisation to regional authorities or planned delegation of financial agreements to the providers, financial incentives are more explicit and may seem to place profit-making above a commitment to better health care. An evaluation of the myths and realities of the decentralization process is needed. Here, I offer an assessment pros and cons of the decentralization process of health care in Spain, drawing on the experience of regional reforms from the pioneering organisational innovations implemented in Catalonia in 1981, up to the observed dispersion of health care spending per capita among regions at present.

Do institutional changes affect business cycles? Evidence from Europe

We study the effects that the Maastricht treaty, the creation of the ECB, andthe Euro changeover had on the dynamics of European business cycles using a panelVAR and data from ten European countries - seven from the Euro area and threeoutside of it. There are changes in the features of European business cycles and in thetransmission of shocks. They precede the three events of interest and are more linkedto a general process of European convergence and synchronization.

Neglected risks, financial innovation and financial fragility

We present a standard model of financial innovation, in which intermediaries engineer securities with cash flows that investors seek, but modify two assumptions. First, investors (and possibly intermediaries) neglect certain unlikely risks. Second, investors demand securities with safe cash flows. Financial intermediaries cater to these preferences and beliefs by engineering securities perceived to be safe but exposed to neglected risks. Because the risks are neglected, security issuance is excessive. As investors eventually recognize these risks, they fly back to safety of traditional securities and markets become fragile, even without leverage, precisely because the volume of new claims is excessive.

Whole brain radiotherapy with a conformational external beam radiation boost for lung cancer patients with 1-3 brain metastasis: a multi institutional study.

BACKGROUND: To determine the outcome of patients with brain metastasis (BM) from lung cancer treated with an external beam radiotherapy boost (RTB) after whole brain radiotherapy (WBRT). METHODS: A total of 53 BM patients with lung cancer were treated sequentially with WBRT and RTB between 1996 and 2008 according to our institutional protocol. Mean age was 58.8 years. The median KPS was 90. Median recursive partitioning analysis (RPA) and graded prognostic assessment (GPA) grouping were 2 and 2.5, respectively. Surgery was performed on 38 (71%) patients. The median number of BM was 1 (range, 1-3). Median WBRT and RTB combined dose was 39 Gy (range, 37.5-54). Median follow-up was 12.0 months. RESULTS: During the period of follow-up, 37 (70%) patients died. The median overall survival (OS) was 14.5 months. Only 13 patients failed in the brain. The majority of patients (n = 29) failed distantly. The 1-year OS, -local control, extracranial failure rates were 61.2%, 75.2% and 60.8%, respectively. On univariate analysis, improved OS was found to be significantly associated with total dose (< or = 39 Gy vs. > 39 Gy; p < 0.01), age < 65 (p < 0.01), absence of extracranial metastasis (p < 0.01), GPA > or = 2.5 (p = 0.01), KPS > or = 90 (p = 0.01), and RPA < 2 (p = 0.04). On multivariate analysis, total dose (p < 0.01) and the absence of extracranial metastasis (p = 0.03) retained statistical significance. CONCLUSIONS: The majority of lung cancer patients treated with WBRT and RTB progressed extracranially. There might be a subgroup of younger patients with good performance status and no extracranial disease who may benefit from dose escalation after WBRT to the metastatic site.

Speculative securities

A speculative security is an asset whose payoff depends on a random shock uncorrelated with economic fundamentals (a sunspot) about which some traders have superior information. In this paper we show that agents may find it desirable to trade such a security in spite of the fact that it is a poorer hedge against their endowment risks as the time oftrade, and has an associated adverse selection cost. In the specific institutional setting of innovation of futures contracts, we show that a futures exchange may not have an incentive to introduce a speculative security even when all traders favor it.

Complementarity between technology make and buy in innovation strategies: Evidence from Belgiam manufacturing firms

This paper characterizes the innovation strategy of manufacturing firms andexamines the relation between the innovation strategy and importantindustry-, firm- and innovation-specific characteristics using Belgiandata from the Eurostat Community Innovation Survey. In addition to importantsize effects explaining innovation, we find that high perceived risks andcosts and low appropriability of innovations do not discourage innovation,but rather determine how the innovation sourcing strategy is chosen. Withrespect to the determinants of the decision of the innovative firm toproduce technology itself (Make) or to source technology externally (Buy),we find that small firms are more likely restrict their innovation strategyto an exclusive make or buy strategy, while large firms are more likely tocombine both internal and external knowledge acquisition in their innovationstrategy. An interesting result that highlights the complementary nature ofthe Make and Buy decisions, is that, controlled for firm size, companies forwhich internal information is an important source for innovation are morelikely to combine internal and external sources of technology. We find thisto be evidence of the fact that in-house R&D generates the necessaryabsorptive capacity to profit from external knowledge acquisition. Also theeffectiveness of different mechanisms to appropriate the benefits ofinnovations and the internal organizational resistance against change areimportant determinants of the firm's technology sourcing strategy.