Determinants of Firm Growth with respect to Exporting and Innovation Activities: Evidence from Egyptian SMEs

Small and medium-sized enterprises (SMEs) are considered to be the driving engine for employment growth, source of innovation and technological progress. Moreover, the success of small exporters is critical for economic growth and is considered as an important development stage for many SMEs. However, their competitive advantage lies within the firm’s ability to innovate. This thesis contributes to the above literature by examining two main factors believed to promote firm growth namely ‘exporting’ and ‘innovation’ activities. Growing interests on the relationship between exporting, innovation and growth have recently been tackled. However, there remains a gap in literature on the relationship between exporting, innovation and firm growth for SMEs in emerging economies. Previous studies are conducted in developed counties such as UK, Ireland, USA, Germany, and Switzerland, which leaves the gap for those developing countries. Thus, this thesis addresses the gap by examining the importance of innovation and exporting activities in the growth of SMEs in Egypt. It is also the researcher’s intent to recognise the unique contribution of innovation on firm exporting activities covering all sectors. gypt, one of the countries that were tremendously affected by the so-called ‘Arab Spring revolution’, is suffering from slow economic growth, high unemployment and poverty rate. Thus, the government must ensure economic growth and job creation. Programmes to encourage and develop SMEs should be part of inclusive growth strategy. Meanwhile, exporting is regarded as a key factor to help the economy recover from recession and stimulate economic growth. On the other hand, innovation leads to better performance in terms of growth, exporting and productivity. Therefore, SMEs and their exporting and innovation activities should be an integral part of any recovery and growth strategy for the economy. Moreover, Egypt is suffering from the so-called ‘Missing Middle’, which is problematic as medium firms tend to provide better employment growth and productivity. Therefore, more light is to shed on the importance of exporting and innovation in the growth of firms. The research design was quantitative in nature, testing the proposed hypotheses. The study was conducted in 2013 based on questionnaires of 406 Egyptians SMEs. The results of the empirical study suggest that both exporting and innovation activities are important in firm growth. However, the results show that, after controlling for endogeneity, innovation does not affect exporting activities in SMEs.

Help in finding the right balance:leadership, work-family balance and employee outcomes

Although much research has examined employees’ experience of the work-family interface, its conceptualization has been rather problematic, ranging from work and family as mutually constraining through to mutually enriching and, more recently, to work-family balance (WFB). Building on Greenhaus and Allen’s (2011) conceptualization of WFB as comprising satisfaction and effectiveness components, I proposed and tested a model of he antecedents and outcomes of WFB. Based on work-family border theory, I hypothesised that family-supportive supervisor behaviours (FSSB) facilitate WFB and hat the relationship is stronger when the organisation also offers formal support (availability of family-friendly practices (FFPs); enhancement effect). Furthermore, I integrated the leadership and work-family interface literatures by proposing authentic eadership as an antecedent of FSSB. Based on role accumulation theories, I proposed life satisfaction and health as outcomes of WFB satisfaction and WFB effectiveness and job performance as an outcome of only WFB effectiveness. I tested my hypotheses with individual-level data in Study 1 (two waves of data; employees from Germany and the UK) and nested data (individuals nested in teams; two waves of data; employee and supervisor ratings; Germany and the UK) in Study 2. The obtained findings largely supported the hypothesized model and showed that both authentic leadership (Study 1) and team authentic leadership (Study 2) predicted FSSB which, in turn, increased WFB satisfaction and WFB effectiveness. Contrary to my prediction, both studies revealed that FSSB and (team) availability of FFPs compensated for each other, only impacting WFB satisfaction/effectiveness if the other form of family support was not available. Furthermore, both components were positively related to life satisfaction and health, while WFB effectiveness was only related to self-rated performance (Study 1) and not supervisor-rated performance (Study 2). Lastly, the serial moderated mediation model hat tested the conditional indirect effect of (team) authentic leadership on the outcomes received mixed support.

Determinants of firm growth with repect to exporting and innovation activities:evidence from Egyptian SMEs

Small and medium-sized enterprises (SMEs) are considered to be the driving engine for employment growth, source of innovation and technological progress. Moreover, the success of small exporters is critical for economic growth and is considered as an important development stage for many SMEs. However, their competitive advantage lies within the firm’s ability to innovate. This thesis contributes to the above literature by examining two main factors believed to promote firm growth namely ‘exporting’ and ‘innovation’ activities. Growing interests on the relationship between exporting, innovation and growth have recently been tackled. However, there remains a gap in literature on the relationship between exporting, innovation and firm growth for SMEs in emerging economies. Previous studies are conducted in developed counties such as UK, Ireland, USA, Germany, and Switzerland, which leaves the gap for those developing countries. Thus, this thesis addresses the gap by examining the importance of innovation and exporting activities in the growth of SMEs in Egypt. It is also the researcher’s intent to recognise the unique contribution of innovation on firm exporting activities covering all sectors. Egypt, one of the countries that were tremendously affected by the so-called ‘Arab Spring revolution’, is suffering from slow economic growth, high unemployment and poverty rate. Thus, the government must ensure economic growth and job creation. Programmes to encourage and develop SMEs should be part of inclusive growth strategy. Meanwhile, exporting is regarded as a key factor to help the economy recover from recession and stimulate economic growth. On the other hand, innovation leads to better performance in terms of growth, exporting and productivity. Therefore, SMEs and their exporting and innovation activities should be an integral part of any recovery and growth strategy for the economy. Moreover, Egypt is suffering from the so-called ‘Missing Middle’, which is problematic as medium firms tend to provide better employment growth and productivity. Therefore, more light is to shed on the importance of exporting and innovation in the growth of firms. The research design was quantitative in nature, testing the proposed hypotheses. The study was conducted in 2013 based on questionnaires of 406 Egyptians SMEs. The results of the empirical study suggest that both exporting and innovation activities are important in firm growth. However, the results show that, after controlling for endogeneity, innovation does not affect exporting activities in SMEs.

Norms and Greek foreign policy: 1981--2000

From the end of WWII to the end of the Cold War Greek foreign policy was shaped by the dynamics of the Cold War. The major issues facing Greek foreign policy decision makers in the post-cold war era are its relations with its Northern neighbors, Albania, The Former Yugoslav Republic of Macedonia (FYROM), and Bulgaria, its relations with Turkey, and Greece's future in the European Union. Although the three issues overlap there is consensus among the Greek political elite that the relationship with Turkey is the most pressing since Turkey poses the most immediate security threat. In the last twenty-five years the two countries came to the verge of war three times over the continental shelf in the Aegean and Cyprus. The latest crisis was in 1996. Since then Greek policy makers have embarked on a conciliatory road towards Turkey that has gained momentum in the last three years. The purpose of this dissertation is to describe the process of the recent change in Greek foreign policy vis-à-vis Turkey, as reflected in the words and deeds (speeches, interviews, statements, policies) of the Greek policy makers. In addition, the study seeks to understand how this change is related to rules existing at the global, regional, and domestic levels. The central question to be asked is: how do rules existing at these levels regulate and constitute the foreign policy process of the Greek government. I utilize the theoretical insights and concepts provided by constructivism in order to carry out my research. The analysis establishes the relationship between the agents (Greek foreign policy makers) and the various rules and explores this relationship as an ongoing process by ascertaining the social context within which this process is unfolding. ^

Electoral rules and elite recruitment: A comparative analysis of the Bundestag and the U.S. House of Representatives

In this research, I analyze the effects of candidate nomination rules and campaign financing rules on elite recruitment into the national legislatures of Germany and the United States. This dissertation is both theory-driven and constitutes exploratory research, too. While the effects of electoral rules are frequently studied in political science, the emphasis is thereby on electoral rules that are set post-election. My focus, in contrast, is on electoral rules that have an effect prior to the election. Furthermore, my dissertation is comparative by design.^ The research question is twofold. Do electoral rules have an effect on elite recruitment, and does it matter? To answer these question, I create a large-N original data set, in which I code the behavior and recruitment paths and patterns of members of the American House of Representatives and the German Bundestag. Furthermore, I include interviews with members of the said two national legislatures. Both the statistical analyses and the interviews provide affirmative evidence for my working hypothesis that differences in electoral rules lead to a different type of elite recruitment. To that end, I use the active-politician concept, through which I dichotomously distinguish the economic behavior of politicians.^ Thanks to the exploratory nature of my research, I also discover the phenomenon of differential valence of local and state political office for entrance into national office in comparative perspective. By statistically identifying this hitherto unknown paradox, as well as evidencing the effects of electoral rules, I show that besides ideology and culture, institutional rules are key in shaping the ruling elite. The way institutional rules are set up, in particular electoral rules, does not only affect how the electorate will vote and how seats will be distributed, but it will also affect what type of people will end up in elected office.^

Biogeochemical, sedimentological and isotopic sediment record of Lake Dojran

A Late Glacial to Holocene sediment sequence (Co1260, 717 cm) from Lake Dojran, located at the boarder of the F.Y.R. of Macedonia and Greece, has been investigated to provide information on climate variability in the Balkan region. A robust age-model was established from 13 radiocarbon ages, and indicates that the base of the sequence was deposited at ca. 12 500 cal yr BP, when the lake-level was low. Variations in sedimentological (H2O, TOC, CaCO3, TS, TOC/TN, TOC/TS, grain-size, XRF, d18Ocarb, d13Ccarb, d13Corg) data were linked to hydro-acoustic data and indicate that warmer and more humid climate conditions characterised the remaining period of the Younger Dryas until the beginning of the Holocene. The Holocene exhibits significant environmental variations, including the 8.2 and 4.2 ka cooling events, the Medieval Warm Period and the Little Ice Age. Human induced erosion processes in the catchment of Lake Dojran intensified after 2800 cal yr BP.

Pollen from 50 lake surface samples in Brandenburg, Germany, in 2009

Past changes in plant and landscape diversity can be evaluated through pollen analysis, however, pollen based diversity indexes are potentially biased by differential pollen production and deposition. Studies examining the relationship between pollen and landscape diversity are therefore needed. The aim of this study is to evaluate how different pollen based indexes capture aspects of landscape diversity. Pollen counts were obtained from surface samples of 50 small to medium sized lakes in Brandenburg (Northeast Germany) and compiled into two sets, with one containing all pollen counts from terrestrial plants and the second restricted to wind-pollinated taxa. Both sets were adjusted for the pollen production/dispersal bias using the REVEALS model. A high resolution biotope map was used to extract the density of total biotopes and different biotopes per area as parameters describing landscape diversity. In addition tree species diversity was obtained from forest inventory data. The Shannon index and the number of taxa in a sample of 10 pollen grains are highly correlated and provide a useful measure of pollen type diversity which corresponds best to landscape diversity within one km of the lake and the proportion of non-forested area within seven km. Adjustments of the pollen production/dispersal bias only slightly improve the relationships between pollen diversity and landscape diversity for the restricted dataset as well as for the forest inventory data and corresponding pollen types. Using rarefaction analysis, we propose the following convention: pollen type diversity is represented by the number of types in a small sample (low count e.g. 10), pollen type richness is the number of types in a large sample (high count e.g. 500) and pollen sample evenness is characterized by the ratio of the two. Synthesis. Pollen type diversity is a robust index that captures vegetation structure and landscape diversity. It is ideally suited for between site comparisons as it does not require high pollen counts. In concert with pollen type richness and evenness, it helps evaluating the effect of climate change and human land use on vegetation structure on long timescales.

Who needs evidence? Radical Feminism, the Christian Right and sex work research in Northern Ireland

This chapter describes my experiences of conducting research on commercial sex in Belfast, Northern Ireland which was conducted as part of a larger British Academy – Leverhulme Trust funded study that examined the policing and legal regulation of commercial sex in Belfast (Northern Ireland) along with three other cities: Manchester (England), Berlin (Germany) and Prague (Czech Republic). This study provided the first empirical analysis of commercial sex in the jurisdiction and was instrumental in shedding light on prevalence rates for those involved in the industry as well as providing demographic information on the age, nationality and sexual orientation of sex workers along with the sector worked in, whether on-street or off-street. In the chapter I consider my role as a researcher and highlight some of the difficulties that I experienced conducting what was seen as controversial research in the politically, socially and culturally conservative context of Northern Ireland.

Sepsis: the LightCycler SeptiFast Test MGRADE®, SepsiTest™ and IRIDICA BAC BSI assay for rapidly identifying bloodstream bacteria and fungi – a systematic review and economic evaluation

Background: Sepsis can lead to multiple organ failure and death. Timely and appropriate treatment can reduce in-hospital mortality and morbidity. Objectives: To determine the clinical effectiveness and cost-effectiveness of three tests [LightCycler SeptiFast Test MGRADE® (Roche Diagnostics, Risch-Rotkreuz, Switzerland); SepsiTest™ (Molzym Molecular Diagnostics, Bremen, Germany); and the IRIDICA BAC BSI assay (Abbott Diagnostics, Lake Forest, IL, USA)] for the rapid identification of bloodstream bacteria and fungi in patients with suspected sepsis compared with standard practice (blood culture with or without matrix-absorbed laser desorption/ionisation time-offlight mass spectrometry). Data sources: Thirteen electronic databases (including MEDLINE, EMBASE and The Cochrane Library) were searched from January 2006 to May 2015 and supplemented by hand-searching relevant articles. Review methods: A systematic review and meta-analysis of effectiveness studies were conducted. A review of published economic analyses was undertaken and a de novo health economic model was constructed. A decision tree was used to estimate the costs and quality-adjusted life-years (QALYs) associated with each test; all other parameters were estimated from published sources. The model was populated with evidence from the systematic review or individual studies, if this was considered more appropriate (base case 1). In a secondary analysis, estimates (based on experience and opinion) from seven clinicians regarding the benefits of earlier test results were sought (base case 2). A NHS and Personal Social Services perspective was taken, and costs and benefits were discounted at 3.5% per annum. Scenario analyses were used to assess uncertainty. Results: For the review of diagnostic test accuracy, 62 studies of varying methodological quality were included. A meta-analysis of 54 studies comparing SeptiFast with blood culture found that SeptiFast had an estimated summary specificity of 0.86 [95% credible interval (CrI) 0.84 to 0.89] and sensitivity of 0.65 (95% CrI 0.60 to 0.71). Four studies comparing SepsiTest with blood culture found that SepsiTest had an estimated summary specificity of 0.86 (95% CrI 0.78 to 0.92) and sensitivity of 0.48 (95% CrI 0.21 to 0.74), and four studies comparing IRIDICA with blood culture found that IRIDICA had an estimated summary specificity of 0.84 (95% CrI 0.71 to 0.92) and sensitivity of 0.81 (95% CrI 0.69 to 0.90). Owing to the deficiencies in study quality for all interventions, diagnostic accuracy data should be treated with caution. No randomised clinical trial evidence was identified that indicated that any of the tests significantly improved key patient outcomes, such as mortality or duration in an intensive care unit or hospital. Base case 1 estimated that none of the three tests provided a benefit to patients compared with standard practice and thus all tests were dominated. In contrast, in base case 2 it was estimated that all cost per QALY-gained values were below £20,000; the IRIDICA BAC BSI assay had the highest estimated incremental net benefit, but results from base case 2 should be treated with caution as these are not evidence based. Limitations: Robust data to accurately assess the clinical effectiveness and cost-effectiveness of the interventions are currently unavailable. Conclusions: The clinical effectiveness and cost-effectiveness of the interventions cannot be reliably determined with the current evidence base. Appropriate studies, which allow information from the tests to be implemented in clinical practice, are required.

Tanzanian Food Origins and Protected Geographical Indications

As the world`s population is constantly growing, food security will remain on the policy Agenda, particularly in Africa. At the same time, global food systems experience a new wave focusing on local foods and food sovereignty featuring high quality food products of verifiable geographical origin. This article argues that Geographical Indications (GI´s) hold the potential to help transform the Tanzanian agriculture-dependent economy through the tapping of value from unique products, attributing taste and colour to place or regional geography. This study aims to identify the existence and characteristics of food origin products in Tanzania that have potential for GI certification. The hypothesis was that there are origin products in Tanzania whose unique characteristics are linked to the area of production. Geographical indications can be useful policy instruments contributing to food security and sovereignty and quality within an efficient marketing system with the availability of government support, hence the need to identify key candidates for GI certification. Five Tanzanian origin products were selected from 14 candidate agricultural products through a scoping study. Rice from Kyela, Aloe vera, Coffee and Sugar from Kilimanjaro and Cloves from Zanzibar are some of the product cases investigated and provides for in-depth case study, as ´landscape´ products incorporating ´taste of place´. Interviews were conducted to collect quantitative and qualitative data. Data was collected on the production area, product quality perceived by the consumer in terms of taste, flavour, texture, aroma, appearance (colour, size) and perceptions of links between geography related factors (soil, land weather characteristics) and product qualities. A qualitative case study analysis was done for each of the (five) selected Tanzanian origin products investigated with plausible prospects for Tanzania to leapfrog into exports of Geographical Indications products. Framework conditions for producers creating or capturing market value as stewards of cultural and landscape values, environments, and institutional requirements for such creation or capturing to happen, including presence of export opportunities, are discussed. Geographical indication is believed to allow smallholders to create employment and build monetary value, while stewarding local food cultures and natural environments and resources, and increasing the diversity of supply of natural and unique quality products and so contribute to enhanced food security.

Use of farmer-prioritized vertisol management options for enhanced green gram and tomato production in central Kenya

Green grams (Phaseolus aures L.) and tomato (Solanum lycopersicum L) are widely grown in the vertisols of the Mwea Irrigation Scheme alongside the rice fields. Green grams can fix nitrogen (biological nitrogen fixation) and are grown for its highly nutritious and curative seeds while tomatoes are grown for its fruit rich in fibres, minerals and vitamins. The two can be prepared separately or together in a variety of ways including raw salads and/or cooked/fried. They together form significant delicacies consumed with rice which is the major cash crop grown in the black cotton soils. The crops can grow well in warm conditions but tomato is fairly adaptable except under excessive humidity and temperatures that reduce yields. Socio-economic prioritization by the farming community and on-farm demonstrations of soil management options were instituted to demonstrate enhanced green gram and tomato production in vertisol soils of lower parts of Kirinyaga County (Mwea East and Mwea West districts). Drainage management was recognized by the farming community as the best option although a reduced number of farmers used drainage and furrows/ridges, manure, fertilizer and shifting options with reducing order of importance. Unavailability of labour and/or financial cost for instituting these management options were indicated as major hindrances to adopt the yield enhancing options. Labour force was contributed to mainly by the family alongside hiring (64.2%) although 28% and 5.2% respectively used hired or family labour alone. The female role in farming activities dominated while the male role was minimal especially at weeding. The youth role remained excessively insignificant and altogether absent at marketing. Despite the need for labour at earlier activities (especially when management options needed to be instituted) it was at the marketing stage that this force was directed. Soils were considered infertile by 60% but 40% indicated that their farms had adequate fertility. Analysis showed that ridging and application of farm yard manure and fertilizer improved fertility, crop growth and income considerably. Phosphate and zinc enhancement reduced alkalinity and sodicity. Green gram and tomato yields increased under ridges and farm yard manure application by 17-25% which significantly enhanced household income.

Review of the flood risk management system in Germany after the major flood in 2013

Widespread flooding in June 2013 caused damage costs of €6 to 8 billion in Germany, and awoke many memories of the floods in August 2002, which resulted in total damage of €11.6 billion and hence was the most expensive natural hazard event in Germany up to now. The event of 2002 does, however, also mark a reorientation toward an integrated flood risk management system in Germany. Therefore, the flood of 2013 offered the opportunity to review how the measures that politics, administration, and civil society have implemented since 2002 helped to cope with the flood and what still needs to be done to achieve effective and more integrated flood risk management. The review highlights considerable improvements on many levels, in particular (1) an increased consideration of flood hazards in spatial planning and urban development, (2) comprehensive property-level mitigation and preparedness measures, (3) more effective flood warnings and improved coordination of disaster response, and (4) a more targeted maintenance of flood defense systems. In 2013, this led to more effective flood management and to a reduction of damage. Nevertheless, important aspects remain unclear and need to be clarified. This particularly holds for balanced and coordinated strategies for reducing and overcoming the impacts of flooding in large catchments, cross-border and interdisciplinary cooperation, the role of the general public in the different phases of flood risk management, as well as a transparent risk transfer system. Recurring flood events reveal that flood risk management is a continuous task. Hence, risk drivers, such as climate change, land-use changes, economic developments, or demographic change and the resultant risks must be investigated at regular intervals, and risk reduction strategies and processes must be reassessed as well as adapted and implemented in a dialogue with all stakeholders.

Physician choice making and characteristics associated with using physician-rating websites: cross-sectional study

BACKGROUND: Over the past decade, physician-rating websites have been gaining attention in scientific literature and in the media. However, little knowledge is available about the awareness and the impact of using such sites on health care professionals. It also remains unclear what key predictors are associated with the knowledge and the use of physician-rating websites. OBJECTIVE: To estimate the current level of awareness and use of physician-rating websites in Germany and to determine their impact on physician choice making and the key predictors which are associated with the knowledge and the use of physician-rating websites. METHODS: This study was designed as a cross-sectional survey. An online panel was consulted in January 2013. A questionnaire was developed containing 28 questions; a pretest was carried out to assess the comprehension of the questionnaire. Several sociodemographic (eg, age, gender, health insurance status, Internet use) and 2 health-related independent variables (ie, health status and health care utilization) were included. Data were analyzed using descriptive statistics, chi-square tests, and t tests. Binary multivariate logistic regression models were performed for elaborating the characteristics of physician-rating website users. Results from the logistic regression are presented for both the observed and weighted sample. RESULTS: In total, 1505 respondents (mean age 43.73 years, SD 14.39; 857/1505, 57.25% female) completed our survey. Of all respondents, 32.09% (483/1505) heard of physician-rating websites and 25.32% (381/1505) already had used a website when searching for a physician. Furthermore, 11.03% (166/1505) had already posted a rating on a physician-rating website. Approximately 65.35% (249/381) consulted a particular physician based on the ratings shown on the websites; in contrast, 52.23% (199/381) had not consulted a particular physician because of the publicly reported ratings. Significantly higher likelihoods for being aware of the websites could be demonstrated for female participants (P<.001), those who were widowed (P=.01), covered by statutory health insurance (P=.02), and with higher health care utilization (P<.001). Health care utilization was significantly associated with all dependent variables in our multivariate logistic regression models (P<.001). Furthermore, significantly higher scores could be shown for health insurance status in the unweighted and Internet use in the weighted models. CONCLUSIONS: Neither health policy makers nor physicians should underestimate the influence of physician-rating websites. They already play an important role in providing information to help patients decide on an appropriate physician. Assuming there will be a rising level of public awareness, the influence of their use will increase well into the future. Future studies should assess the impact of physician-rating websites under experimental conditions and investigate whether physician-rating websites have the potential to reflect the quality of care offered by health care providers.

Information Presentation Features and Comprehensibility of Hospital Report Cards: Design Analysis and Online Survey Among Users

Background: Improving the transparency of information about the quality of health care providers is one way to improve health care quality. It is assumed that Internet information steers patients toward better-performing health care providers and will motivate providers to improve quality. However, the effect of public reporting on hospital quality is still small. One of the reasons is that users find it difficult to understand the formats in which information is presented. Objective: We analyzed the presentation of risk-adjusted mortality rate (RAMR) for coronary angiography in the 10 most commonly used German public report cards to analyze the impact of information presentation features on their comprehensibility. We wanted to determine which information presentation features were utilized, were preferred by users, led to better comprehension, and had similar effects to those reported in evidence-based recommendations described in the literature. Methods: The study consisted of 5 steps: (1) identification of best-practice evidence about the presentation of information on hospital report cards; (2) selection of a single risk-adjusted quality indicator; (3) selection of a sample of designs adopted by German public report cards; (4) identification of the information presentation elements used in public reporting initiatives in Germany; and (5) an online panel completed an online questionnaire that was conducted to determine if respondents were able to identify the hospital with the lowest RAMR and if respondents’ hospital choices were associated with particular information design elements. Results: Evidence-based recommendations were made relating to the following information presentation features relevant to report cards: evaluative table with symbols, tables without symbols, bar charts, bar charts without symbols, bar charts with symbols, symbols, evaluative word labels, highlighting, order of providers, high values to indicate good performance, explicit statements of whether high or low values indicate good performance, and incomplete data (“N/A” as a value). When investigating the RAMR in a sample of 10 hospitals’ report cards, 7 of these information presentation features were identified. Of these, 5 information presentation features improved comprehensibility in a manner reported previously in literature. Conclusions: To our knowledge, this is the first study to systematically analyze the most commonly used public reporting card designs used in Germany. Best-practice evidence identified in international literature was in agreement with 5 findings about German report card designs: (1) avoid tables without symbols, (2) include bar charts with symbols, (3) state explicitly whether high or low values indicate good performance or provide a “good quality” range, (4) avoid incomplete data (N/A given as a value), and (5) rank hospitals by performance. However, these findings are preliminary and should be subject of further evaluation. The implementation of 4 of these recommendations should not present insurmountable obstacles. However, ranking hospitals by performance may present substantial difficulties.

Between Bacchus and Dionysus: European Union policies on rural development: the cases of Nemea and Basto wine regions

A actividade vitivinícola possui um conjunto diverso de características presentes no solo, território e comunidade que fazem parte do património cultural de uma determinada região. Quando a tradição se traduz num conceito como terroir que é formado por características territoriais, sociais e culturais de uma região rural, o vinho apresenta uma “assinatura” que se escreve “naturalmente” no paladar regionalmente identificado. Os vinhos da Região de Nemea, na Grécia e de Basto (Região dos Vinhos Verdes) em Portugal, estão ambos sob a proteção dos regulamentos das Denominações de Origem. No entanto, apesar de ambos serem regulados por sistemas institucionais de certificação e controlo de qualidade, afigura-se a necessidade de questionar se o património cultural e a identidade territorial específica, “impressa” em ambos os terroirs, pode ser protegida num sentido mais abrangente do que apenas origem e qualidade. Em Nemea, a discussão entre os produtores diz respeito ao estabelecimento de sub-zonas, isto é incluir na regulação PDO uma diferente categorização territorial com base no terroir. Ou seja, para além de estar presente no rótulo a designação PDO, as garrafas incluirão ainda informação certificada sobre a área específica (dentro do mesmo terroir) onde o vinho foi produzido. A acontecer resultaria em diferentes status de qualidade de acordo com as diferentes aldeias de Nemea onde as vinhas estão localizadas. O que teria possíveis impactos no valor das propriedades e no uso dos solos. Para além disso, a não participação da Cooperativa de Nemea na SON (a associação local de produtores de vinho) e como tal na discussão principal sobre as mudanças e os desafios sobre o terroir de Nemea constitui um problema no sector vitivinícola de Nemea. Em primeiro lugar estabelece uma relação de não-comunicação entre os dois mais importantes agentes desse sector – as companhias vinícolas e a Cooperativa. Em segundo lugar porque constituiu uma possibilidade real, não só para os viticultores ficarem arredados dessa discussão, como também (porque não representados pela cooperativa) ficar impossibilitado um consenso sobre as mudanças discutidas. Isto poderá criar um ‘clima’ de desconfiança levando a discussão para ‘arenas’ deslocalizadas e como tal para decisões ‘desterritorializadas’ Em Basto, há vários produtores que começaram a vender a sua produção para distribuidoras localizadas externamente à sub-região de Basto, mas dentro da Região dos Vinhos Verdes, uma vez que essas companhias tem um melhor estatuto nacional e internacional e uma melhor rede de exportações. Isto está ainda relacionado com uma competição por uma melhor rede de contactos e status mais forte, tornando as discussões sobre estratégias comuns para o desenvolvimento rural e regional de Basto mais difícil de acontecer (sobre isto a palavra impossível foi constantemente usada durante as entrevistas com os produtores de vinho). A relação predominante entre produtores é caracterizada por relações individualistas. Contudo foi observado que essas posições são ainda caracterizadas por uma desconfiança no interior da rede interprofissional local: conflitos para conseguir os mesmos potenciais clientes; comprar uvas a viticultores com melhor rácio qualidade/preço; estratégias individuais para conseguir um melhor status político na relação com a Comissão dos Vinhos Verdes. Para além disso a inexistência de uma activa intermediação institucional (autoridades municipais e a Comissão de Vinho Verde), a inexistência entre os produtores de Basto de uma associação ou mesmo a inexistência de uma cooperativa local tem levado a região de Basto a uma posição de subpromoção nas estratégias de promoção do Vinho Verde em comparação com outras sub-regiões. É também evidente pelos resultados que as mudanças no sector vitivinícolas na região de Basto têm sido estimuladas de fora da região (em resposta também às necessidades dos mercados internacionais) e raramente de dentro – mais uma vez, ‘arenas’ não localizadas e como tal decisões desterritorializadas. Nesse sentido, toda essa discussão e planeamento estratégico, terão um papel vital na preservação da identidade localizada do terroir perante os riscos de descaracterização e desterritorialização. Em suma, para ambos os casos, um dos maiores desafios parece ser como preservar o terroir vitivinícola e como tal o seu carácter e identidade local, quando a rede interprofissional em ambas as regiões se caracteriza, tanto por relações não-consensuais em Nemea como pelo modus operandi de isolamento sem comunicação em Basto. Como tal há uma necessidade de envolvimento entre os diversos agentes e as autoridades locais no sentido de uma rede localizada de governança. Assim sendo, em ambas as regiões, a existência dessa rede é essencial para prevenir os efeitos negativos na identidade do produto e na sua produção. Uma estratégia de planeamento integrado para o sector será vital para preservar essa identidade, prevenindo a sua desterritorialização através de uma restruturação do conhecimento tradicional em simultâneo com a democratização do acesso ao conhecimento das técnicas modernas de produção vitivinícola.