Medical and legal professionals' attitudes towards confidentiality and disclosure of clinical information in forensic settings: a survey using case vignettes.

OBJECTIVE: When potentially dangerous patients reveal criminal fantasies to their therapists, the latter must decide whether this information has to be transmitted to a third person in order to protect potential victims. We were interested in how medical and legal professionals handle such situations in the context of prison medicine and forensic evaluations. We aimed to explore the motives behind their actions and to compare these professional groups. METHOD: A mail survey was conducted among medical and legal professionals using five fictitious case vignettes. For each vignette, participants were asked to answer questions exploring what the professional should do in the situation and to explain their justification for the chosen response. RESULTS: A total of 147 questionnaires were analysed. Agreement between participants varied from one scenario to another. Overall, legal professionals tended to disclose information to a third party more easily than medical professionals, the latter tending to privilege confidentiality and patient autonomy over security. Perception of potential danger in a given situation was not consistently associated with actions. CONCLUSION: Professionals' opinions and attitudes regarding the confidentiality of potentially dangerous patients differ widely and appear to be subjectively determined. Shared discussions about clinical situations could enhance knowledge and competencies and reduce differences between professional groups.

Research involving biological material from forensic autopsies: legal and ethical issues.

Recommendations and laws do not always contain specific and clear provisions on the use of cadaveric material in research, and even more rarely do they address explicitly the ethical issues related to research on material obtained during forensic autopsy. In this article we analyse existing legal frameworks in Europe by comparing the legal provisions in 2 European Countries which are member states of the Council of Europe, the UK and Switzerland. They were chosen because they have distinct legal frameworks that make comparisons interesting. In addition, the detailed laws of the UK and a specific law project and national ethical recommendations in Switzerland permit us to define more clearly the legal range of options for researchers using cadaveric material obtained during forensic investigations. The Human Tissue Act 2004 in England, Wales and Northern Ireland, its Scottish equivalent with the same title (2006) and the national ethical guidelines in Switzerland all require consent from the deceased person, an appropriate relative or a person with power of attorney for healthcare decisions before cadaveric biological material can be obtained and used for research. However, if the purpose of the autopsy is purely forensic, no such authorization will be sought to carry out the autopsy and related analyses, which might include genetic testing. In order to be allowed to carry out future research projects, families need to be approached for informed consent, unless the deceased person had left written directives including permission to use his or her tissues for research.

La Fuga de capital humà : una sortida sense retorn

Cert és que l’economia actual està sent transformada per la globalització, la integració econòmica i un increment en l’ús de les noves tecnologies. Una de les conseqüències d’aquest fenòmen és que la força de treball formada està adquirint cada vegada més mobilitat entre països industrialitzats. És precisament aquest el subjecte d’estudi del treball: la fuga de capital humà en el sector de la recerca i el desenvolupament. El nostre treball fa un recorregut per variables com la despesa en R+D, atur en el sector, personal que es dedica a investigació, entre altres. L’objectiu de les quals és arribar a extreure un rànquing de països emissors i receptors de capital humà a nivell europeu. No hem pogut obviar estudiar com ha estat l’evolució de la inversió espanyola a nivell públic i privat. Hem trobat interessant també, afegir el cas d’Estats Units, donat que és el país receptor per excel·lència.Per tenir-ne una visió més directe hem realitzat un pla d’enquestes a estudiants dedoctorats i màsters de la nostra universitat, per tal de veure, entre altres coses, si vertaderament la fuga de capital humà és una sortida sense retorn.

Capital, Wages, and Growth: Theory and Evidence

Returns to scale to capital and the strength of capital externalities play a key role for the empirical predictions and policy implications of different growth theories. We show that both can be identified with individual wage data and implement our approach at the city-level using US Census data on individuals in 173 cities for 1970, 1980, and 1990. Estimation takes into account fixed effects, endogeneity of capital accumulation, and measurement error. We find no evidence for human or physical capital externalities and decreasing aggregate returns to capital. Returns to scale to physical and human capital are around 80 percent. We also find strong complementarities between human capital and labor and substantial total employment externalities.

Human Capital, the Structure of Production, and Growth

Recent decisions by the Spanish national competition authority (TDC) mandate payment systems to include only two costs when setting their domestic multilateral interchange fees (MIF): a fixed processing cost and a variable cost for the risk of fraud. This artificial lowering of MIFs will not lower consumer prices, because of uncompetitive retailing; but it will however lead to higher cardholders fees and, likely, new prices for point of sale terminals, delaying the development of the immature Spanish card market. Also, to the extent that increased cardholders fees do not offset the fall in MIFs revenue, the task of issuing new cards will be underpaid relatively to the task of acquiring new merchants, causing an imbalance between the two sides of the networks. Moreover, the pricing scheme arising from the decisions will cause unbundling and underprovision of those services whose costs are excluded. Indeed, the payment guarantee and the free funding period will tend to be removed from the package of services currently provided, to be either provided by third parties, by issuers for a separate fee, or not provided at all, especially to smaller and medium-sized merchants. Transaction services will also suffer the consequences that the TDC precludes pricing them in variable terms.

Financial Markets and Real Ecinomy: Four Essays in International Trade

Financial markets play an important role in an economy performing various functions like mobilizing and pooling savings, producing information about investment opportunities, screening and monitoring investments, implementation of corporate governance, diversification and management of risk. These functions influence saving rates, investment decisions, technological innovation and, therefore, have important implications for welfare. In my PhD dissertation I examine the interplay of financial and product markets by looking at different channels through which financial markets may influence an economy.My dissertation consists of four chapters. The first chapter is a co-authored work with Martin Strieborny, a PhD student from the University of Lausanne. The second chapter is a co-authored work with Melise Jaud, a PhD student from the Paris School of Economics. The third chapter is co-authored with both Melise Jaud and Martin Strieborny. The last chapter of my PhD dissertation is a single author paper.Chapter 1 of my PhD thesis analyzes the effect of financial development on growth of contract intensive industries. These industries intensively use intermediate inputs that neither can be sold on organized exchange, nor are reference-priced (Levchenko, 2007; Nunn, 2007). A typical example of a contract intensive industry would be an industry where an upstream supplier has to make investments in order to customize a product for needs of a downstream buyer. After the investment is made and the product is adjusted, the buyer may refuse to meet a commitment and trigger ex post renegotiation. Since the product is customized to the buyer's needs, the supplier cannot sell the product to a different buyer at the original price. This is referred in the literature as the holdup problem. As a consequence, the individually rational suppliers will underinvest into relationship-specific assets, hurting the downstream firms with negative consequences for aggregate growth. The standard way to mitigate the hold up problem is to write a binding contract and to rely on the legal enforcement by the state. However, even the most effective contract enforcement might fail to protect the supplier in tough times when the buyer lacks a reliable source of external financing. This suggests the potential role of financial intermediaries, banks in particular, in mitigating the incomplete contract problem. First, financial products like letters of credit and letters of guarantee can substantially decrease a risk and transaction costs of parties. Second, a bank loan can serve as a signal about a buyer's true financial situation, an upstream firm will be more willing undertake relationship-specific investment knowing that the business partner is creditworthy and will abstain from myopic behavior (Fama, 1985; von Thadden, 1995). Therefore, a well-developed financial (especially banking) system should disproportionately benefit contract intensive industries.The empirical test confirms this hypothesis. Indeed, contract intensive industries seem to grow faster in countries with a well developed financial system. Furthermore, this effect comes from a more developed banking sector rather than from a deeper stock market. These results are reaffirmed examining the effect of US bank deregulation on the growth of contract intensive industries in different states. Beyond an overall pro-growth effect, the bank deregulation seems to disproportionately benefit the industries requiring relationship-specific investments from their suppliers.Chapter 2 of my PhD focuses on the role of the financial sector in promoting exports of developing countries. In particular, it investigates how credit constraints affect the ability of firms operating in agri-food sectors of developing countries to keep exporting to foreign markets.Trade in high-value agri-food products from developing countries has expanded enormously over the last two decades offering opportunities for development. However, trade in agri-food is governed by a growing array of standards. Sanitary and Phytosanitary standards (SPS) and technical regulations impose additional sunk, fixed and operating costs along the firms' export life. Such costs may be detrimental to firms' survival, "pricing out" producers that cannot comply. The existence of these costs suggests a potential role of credit constraints in shaping the duration of trade relationships on foreign markets. A well-developed financial system provides the funds to exporters necessary to adjust production processes in order to meet quality and quantity requirements in foreign markets and to maintain long-standing trade relationships. The products with higher needs for financing should benefit the most from a well functioning financial system. This differential effect calls for a difference-in-difference approach initially proposed by Rajan and Zingales (1998). As a proxy for demand for financing of agri-food products, the sanitary risk index developed by Jaud et al. (2009) is used. The empirical literature on standards and norms show high costs of compliance, both variable and fixed, for high-value food products (Garcia-Martinez and Poole, 2004; Maskus et al., 2005). The sanitary risk index reflects the propensity of products to fail health and safety controls on the European Union (EU) market. Given the high costs of compliance, the sanitary risk index captures the demand for external financing to comply with such regulations.The prediction is empirically tested examining the export survival of different agri-food products from firms operating in Ghana, Mali, Malawi, Senegal and Tanzania. The results suggest that agri-food products that require more financing to keep up with food safety regulation of the destination market, indeed sustain longer in foreign market, when they are exported from countries with better developed financial markets.Chapter 3 analyzes the link between financial markets and efficiency of resource allocation in an economy. Producing and exporting products inconsistent with a country's factor endowments constitutes a serious misallocation of funds, which undermines competitiveness of the economy and inhibits its long term growth. In this chapter, inefficient exporting patterns are analyzed through the lens of the agency theories from the corporate finance literature. Managers may pursue projects with negative net present values because their perquisites or even their job might depend on them. Exporting activities are particularly prone to this problem. Business related to foreign markets involves both high levels of additional spending and strong incentives for managers to overinvest. Rational managers might have incentives to push for exports that use country's scarce factors which is suboptimal from a social point of view. Export subsidies might further skew the incentives towards inefficient exporting. Management can divert the export subsidies into investments promoting inefficient exporting.Corporate finance literature stresses the disciplining role of outside debt in counteracting the internal pressures to divert such "free cash flow" into unprofitable investments. Managers can lose both their reputation and the control of "their" firm if the unpaid external debt triggers a bankruptcy procedure. The threat of possible failure to satisfy debt service payments pushes the managers toward an efficient use of available resources (Jensen, 1986; Stulz, 1990; Hart and Moore, 1995). The main sources of debt financing in the most countries are banks. The disciplining role of banks might be especially important in the countries suffering from insufficient judicial quality. Banks, in pursuing their rights, rely on comparatively simple legal interventions that can be implemented even by mediocre courts. In addition to their disciplining role, banks can promote efficient exporting patterns in a more direct way by relaxing credit constraints of producers, through screening, identifying and investing in the most profitable investment projects. Therefore, a well-developed domestic financial system, and particular banking system, would help to push a country's exports towards products congruent with its comparative advantage.This prediction is tested looking at the survival of different product categories exported to US market. Products are identified according to the Euclidian distance between their revealed factor intensity and the country's factor endowments. The results suggest that products suffering from a comparative disadvantage (labour-intensive products from capital-abundant countries) survive less on the competitive US market. This pattern is stronger if the exporting country has a well-developed banking system. Thus, a strong banking sector promotes exports consistent with a country comparative advantage.Chapter 4 of my PhD thesis further examines the role of financial markets in fostering efficient resource allocation in an economy. In particular, the allocative efficiency hypothesis is investigated in the context of equity market liberalization.Many empirical studies document a positive and significant effect of financial liberalization on growth (Levchenko et al. 2009; Quinn and Toyoda 2009; Bekaert et al., 2005). However, the decrease in the cost of capital and the associated growth in investment appears rather modest in comparison to the large GDP growth effect (Bekaert and Harvey, 2005; Henry, 2000, 2003). Therefore, financial liberalization may have a positive impact on growth through its effect on the allocation of funds across firms and sectors.Free access to international capital markets allows the largest and most profitable domestic firms to borrow funds in foreign markets (Rajan and Zingales, 2003). As domestic banks loose some of their best clients, they reoptimize their lending practices seeking new clients among small and younger industrial firms. These firms are likely to be more risky than large and established companies. Screening of customers becomes prevalent as the return to screening rises. Banks, ceteris paribus, tend to focus on firms operating in comparative-advantage sectors because they are better risks. Firms in comparative-disadvantage sectors finding it harder to finance their entry into or survival in export markets either exit or refrain from entering export markets. On aggregate, one should therefore expect to see less entry, more exit, and shorter survival on export markets in those sectors after financial liberalization.The paper investigates the effect of financial liberalization on a country's export pattern by comparing the dynamics of entry and exit of different products in a country export portfolio before and after financial liberalization.The results suggest that products that lie far from the country's comparative advantage set tend to disappear relatively faster from the country's export portfolio following the liberalization of financial markets. In other words, financial liberalization tends to rebalance the composition of a country's export portfolio towards the products that intensively use the economy's abundant factors.

Financial Repression in a Natural Experiment: Loan Allocation and the Change in the Usury Laws in 1714

If financial deepening aids economic growth, then financial repression should be harmful. We use a natural experiment – the change in the English usury laws in 1714 – to analyze the effects of interest rate restrictions. We use a sample of individual loan transactions to demonstrate how the reduction of the legal maximum rate of interest affected the supply and demand for credit. Average loan size and minimum loan size increased strongly, and access to credit worsened for those with little ‘social capital.’ While we have no direct evidence that loans were misallocated, the discontinuity in loan receipts makes this highly likely. We conclude that financial repression can undermine the positive effects of financial deepening.

Adjustment to Target Capital, Finance, and Growth

Does financial development result in capital being reallocated more rapidly to industries where it is most productive? We argue that if this was the case, financially developed countries should see faster growth in industries with investment opportunities due to global demand and productivity shifts. Testing this cross-industry cross-country growth implication requires proxies for (latent) global industry investment opportunities. We show that tests relying only on data from specific (benchmark) countries may yield spurious evidence for or against the hypothesis. We therefore develop an alternative approach that combines benchmark-country proxies with a proxy that does not reflect opportunities specific to a country or level of financial development. Our empirical results yield clear support for the capital reallocation hypothesis.

Capital Social e Expectativas de Carreira de Estudantes de Ascendência Africana

Segundo a literatura, as condições sociais e culturais exercem grandes influências no processo de escolha de carreira. Por outro lado, o capital social pode ser um excelente recurso para conseguir boas oportunidades de emprego no mercado de trabalho. A presente investigação procura estudar o impacto dos antecedentes sociais e do capital social sob as expectativas de carreira de jovens universitários de ascendência africana. A recolha dos dados foi feita através da aplicação de um questionário a vários alunos do ensino superior de várias universidades portuguesas (públicas e privadas), a fim de medir as seguintes variáveis: a auto-eficácia escolar, a instrumentalidade escolar, o locus de controlo, a instrumentalidade no trabalho, a expectativa face ao trabalho, e o capital social. A amostra é constituída por 150 estudantes, 82 do sexo feminino e 66 do sexo masculino, com idades compreendidas entre os 19 e os 44 anos, e 102 estudantes com pais de nacionalidade portuguesa e 45 com pais de nacionalidade africana. Mostram os resultados do presente estudo que a pertença a uma rede social com bons recursos e prestadora de apoio faz desenvolver menos expectativas de dimensões extrínsecas nos estudantes no início de carreira. Ainda, de acordo com os resultados, sabe-se que os estudantes universitários de ascendência africana desenvolvem atitudes mais positivas face à escola e desenvolvem mais expectativas de dimensões extrínsecas face ao trabalho.

Iowa Budget Report Capital Projects, January 2005

This report is of the projects for the capital.

A política de formação de quadros e o capital cultural dos altos funcionários públicos cabo-verdianos

A estratégia de desenvolvimento de Cabo Verde tem passado por um acentuado investimento na formação dos seus recursos humanos, desde a expansão e democratização do ensino básico até à recente criação da Universidade estatal. A aposta numa política de formação de quadros teve de contar com a cooperação com outros países, dada a inexistência de ensino superior nas ilhas e à incapacidade financeira para a sua implementação. Nesta apresentação, pretende-se demonstrar que uma das consequências do investimento na educação foi a constituição de uma elite cujo traço comum é a sua formação académica adquirida fora das ilhas e a capacidade técnica desenvolvida na chefia dos serviços públicos. Desse capital cultural faz parte toda a experiência que conseguiram amealhar no estrangeiro durante o seu período de estudos universitários, debatendo-se com obstáculos linguísticos, culturais, financeiros e, até, identitários, os quais representam uma riqueza adicional ao seu perfil enquanto dirigentes da administração pública cabo-verdiana.

O Impacto Fiscal Decorrente do processo de Rememoração de Activos Fixos Tangíveis

O objectivo deste estudo consiste em evidenciar a politica contabilística de revalorização de activos fixos tangíveis e o seu impacto numa entidade, principalmente a nível da tributação dos rendimentos. A abordagem é direccionada para o meio empresarial cabo-verdiano onde se pretende dar a conhecer o enquadramento legal e fiscal existente, assim como ilustrar com um caso prático. O trabalho foi preparado com base em consulta de bibliografia especializada, de normativos estabelecidos no país e ainda a recolha de dados práticos sobre o tema e entrevistas com profissionais na área. Partimos do geral para o particular, isto é, começamos por trabalhar o conteúdo dos activos fixos tangíveis no geral, para posteriormente entrarmos no objecto de estudo: a revalorização dos activos fixos tangíveis, e assim dar a conhecer os impactos que este tema traz para uma entidade. O trabalho inicia com um enquadramento teórico de conceitos relacionados com os fenómenos que levam com que um bem perca valor ao longo dos anos, assim como outras matérias directamente ligadas às revalorizações (exemplo da manutenção de capital físico e financeiro). É feita uma abordagem normativa e conceitual geral sobre os activos fixos tangíveis: o reconhecimento, a mensuração inicial e subsequente, a divulgação e o Desreconhecimento. É uma abordagem comparativa com o sistema contabilístico anterior (Plano Nacional de Contabilidade). No tratamento da mensuração subsequente dos activos fixos tangíveis introduzimos o estudo da Revalorização do Activos Fixos Tangíveis, referindo as normas contabilísticas e as leis fiscais relacionadas e os impactos que traz para a empresa. aim of this research consist in show evidences about the accounting policy of value of revalorization of Tangible Assets and its impact in an entity, mainly in terms of taxation incoming. The approach is directed to the Cape-Verdean enterprise environment where is intended to give to know the legal and tax framing, as well illustrate with a practical case. This task was prepared based on specialized bibliographic researches, of normative established in the country and also the collecting of practical data about the theme and interviews with professionals in the area. We start from general to particular, that is, we started working on the contents of Tangible Assets in general, to later on get into the study object: the revalorization of Tangible Assets and thus give to know the impacts that this brings to an entity. The task tarts with the theoretical framing of concepts related with the phenomenon that lead one good lose its value along the years, as well other material goods directly connected to revalorization (example of maintenance of physical and financial capital). It is made a normative and general conceptual approach about the Tangible Assets: the recognizing, the measurable initiate and subsequently, the divulgation and the unknown. It is a comparative approach with the previous accounting system (National Accounting Plan). In the treatment of the measurable of Tangible Assets we introduced the study of Revalorization of Tangible Assets, referring the accounting rules and the related fiscal laws and the impacts that bring to the company.