A comparative analysis of hospital -based physician monitoring systems

The purpose of the multiple case-study was to determine how hospital subsystems (such as physician monitoring and credentialing; quality assurance; risk management; and peer review) were supporting the monitoring of physicians? Three large metropolitan hospitals in Texas were studied and designated as hospitals #1, #2, and #3. Realizing that hospital subsystems are a unique entity and part of a larger system, conclusions were made on the premises of a quality control system, in relation to the tools of government (particularly the Health Care Quality Improvement Act (HCQIA)), and in relation to itself as a tool of a hospital.^ Three major analytical assessments were performed. First, the subsystems were analyzed as to their "completeness"; secondly, the subsystems were analyzed for "performance"; and thirdly, the subsystems were analyzed in reference to the interaction of completeness and performance.^ The physician credentialing and monitoring and the peer review subsystems as quality control systems were most complete, efficient, and effective in hospitals #1 and #3. The HCQIA did not seem to be an influencing factor in the completeness of the subsystem in hospital #1. The quality assurance and risk management subsystem in hospital #2 was not representative of completeness and performance and the HCQIA was not an influencing factor in the completeness of the Q.A. or R.M. systems in any hospital. The efficiency (computerization) of the physician credentialing, quality assurance and peer review subsystems in hospitals #1 and #3 seemed to contribute to their effectiveness (system-wide effect).^ The results indicated that the more complete, effective, and efficient subsystems were characterized by (1) all defined activities being met, (2) the HCQIA being an influencing factor, (3) a decentralized administrative structure, (4) computerization an important element, and (5) staff was sophisticated in subsystem operations. However, other variables were identified which deserve further research as to their effect on completeness and performance of subsystems. They include (1) medical staff affiliations, (2) system funding levels, (3) the system's administrative structure, and (4) the physician staff "cultural" characteristics. Perhaps by understanding other influencing factors, health care administrators may plan subsystems that will be compatible with legislative requirements and administrative objectives. ^

Factors Underlying the Formation of Industrial Clusters in Japan and Industrial Cluster Policy: A Quantitative Survey

The purpose of this report is to use information provided by a questionnaire survey to analyze the factors and processes underlying the formation of industrial clusters in Japan. The study, based on questionnaire surveys, forms part of an "Industrial Cluster Project". The Japanese government has implemented policies for industrial clusters so as to enable Japanese industries to maintain competitive power in global markets, and to aid the self-sufficient expansion of local industries. The government's project goes under the heading "Industry Agglomeration for the Recovery of Local Industries with respect to so-called "Industry Clusters." The authors aim to identify what expectations are held of government by the enterprises that make up industrial clusters. As part of our investigation, we used the results of a survey conducted by UNDP in 2004. Tsuji's study, published by the Osaka School of International Public Policy, surveyed 1198 small or medium sized manufacturing companies located in O ward, Tokyo and Higashi Osaka city, Osaka prefecture. The outcome of the present study, together with data from Tsuji's work on IT usage by SMEs in Japan, is meant to form the basis for policy design and implementation.

Decentralization in Nation State Building of Indonesia

Introduction：Today, many countries, regardless of developed or developing, are trying to promote decentralization. According to Manor, as his quoting of Nickson’s argument, decentralization stems from the necessity to strengthen local governments as proxy of civil society to fill the yawning gap between the state and civil society (Manor [1999]: 30). With the end to the Cold War following the collapse of the Soviet Union rendering the cause of the “leadership of the central government to counter communism” meaningless, Manor points out, it has become increasingly difficult to respond flexibly to changes in society under the centralized system. Then, what benefits can be expected from the effectuation of decentralization? Litvack-Ahmad-Bird cited the four points: attainment of allocative efficiency in the face of different local preferences for local public goods; improvement to government competitiveness; realization of good governance; and enhancement of the legitimacy and sustainability of heterogeneous national states (Litvack, Ahmad & Bird [1998]: 5). They all contribute to reducing the economic and social costs of a central government unable to respond to changes in society and enhancing the efficiency of state administration through the delegation of authority to local governments. Why did Indonesia have a go at decentralization? As Maryanov recognizes, reasons for the implementation of decentralization in Indonesia have never been explicitly presented (Maryanov [1958]: 17). But there was strong momentum toward building a democratic state in Indonesia at the time of independence, and as indicated by provisions of Article 18 of the 1945 Constitution, there was the tendency in Indonesia from the beginning to debate decentralization in association with democratization. That said debate about democratization was fairly abstract and the main points are to ease the tensions, quiet the complaints, satisfy the political forces and thus stabilize the process of government (Maryanov [1958]: 26-27). 　　　What triggered decentralization in Indonesia in earnest, of course, was the collapse of the Soeharto regime in May 1998. The Soeharto regime, regarded as the epitome of the centralization of power, became incapable of effectively dealing with problems in administration of the state and development administration. Besides, the post-Soeharto era of “reform (reformasi)” demanded the complete wipeout of the Soeharto image. In contraposition to the centralization of power was decentralization. The Soeharto regime that ruled Indonesia for 32 years was established in 1966 under the banner of “anti-communism.” The end of the Cold War structure in the late 1980s undermined the legitimate reason the centralization of power to counter communism claimed by the Soeharto regime. The factor for decentralization cited by Manor is applicable here. 　　　Decentralization can be interpreted to mean not only the reversal of the centralized system of government due to its inability to respond to changes in society, as Manor points out, but also the participation of local governments in the process of the nation state building through the more positive transfer of power (democratic decentralization) and in the coordinated pursuit with the central government for a new shape of the state. However, it is also true that a variety of problems are gushing out in the process of implementing decentralization in Indonesia. 　　　This paper discusses the relationship between decentralization and the formation of the nation state with the awareness of the problems and issues described above. Section 1 retraces the history of decentralization by examining laws and regulations for local administration and how they were actually implemented or not. Section 2 focuses on the relationships among the central government, local governments, foreign companies and other actors in the play over the distribution of profits from exploitation of natural resources, and examines the process of the ulterior motives of these actors and the amplification of mistrust spawning intense conflicts that, in extreme cases, grew into separation and independence movements. Section 3 considers the merits and demerits at this stage of decentralization implemented since 2001 and shed light on the significance of decentralization in terms of the nation state building. Finally, Section 4 attempts to review decentralization as the “opportunity to learn by doing” for the central and local governments in the process of the nation state building. 　　　In the context of decentralization in Indonesia, deconcentration (dekonsentrasi), decentralization (desentralisasi) and support assignments (tugas pembantuan; medebewind, a Dutch word, was used previously) are defined as follows. Dekonsentrasi means that when the central government puts a local office of its own, or an outpost agency, in charge of implementing its service without delegating the administrative authority over this particular service. The outpost agency carries out the services as instructed by the central government. A head of a local government, when acting for the central government, gets involved in the process of dekonsentrasi. Desentralisasi, meanwhile, occurs when the central government cedes the administrative authority over a particular service to local governments. Under desentralisasi, local governments can undertake the particular service at their own discretion, and the central government, after the delegation of authority, cannot interfere with how local governments handle that service. Tugas pembantuan occur when the central government makes local governments or villages, or local governments make villages, undertake a particular service. In this case, the central government, or local governments, provides funding, equipment and materials necessary, and officials of local governments and villages undertake the service under the supervision and guidance of the central or local governments. Tugas pembantuan are maintained until local governments and villages become capable of undertaking that particular service on their own.

Politics of the 1945 Constitution:Democratization and Its Impact on Political Institutions in Indonesia

Introduction : Before 1998, no one could think about the amendment of the 1945 Constitution. The 1945 Constitution was a product of nationalist who had hard fought for independence from the Dutch colonization. This historical background made it the symbol of independence of the Indonesian nation. Thus, it has been considered as forbidden to touch contents of the 1945 Constitution whereas political leaders have legitimized their authoritarian rulership by utilizing a symbolic character of the Constitution. With the largest political turmoil since its independence, that is, a breakdown of authoritarian regime and democratic transformation in 1998-1999, however, a myth of the "sacred and inviolable" constitution has disappeared. A new theme has then aroused: how can the 1945 Constitution be adapted for a new democratic regime in Indonesia? 　　　The Indonesian modern state has applied the 1945 Constitution as the basic law since its independence in 1945, except for around 10 years in the 1950s. In the period of independence struggle, contrary to the constitutional provision that a kind of presidential system is employed, a cabinet responsible for the Central National Committee was installed. Politics under this institution was in practice a parliamentary system of government. After the Dutch transferred sovereignty to Indonesia in 1949, West European constitutionalism and party politics under a parliamentary system was fully adopted with the introduction of two new constitutions: the 1949 Constitution of Federal Republic of Indonesia and the 1950 Provisional Constitution of Republic of Indonesia. Since a return from the 1950 Constitution to the 1945 Constitution was decided with the Presidential Decree in 1959, the 1945 Constitution had supported two authoritarian regimes of Soekarno's "Guided Democracy" and Soeharto's "New Order" as a legal base. When the 32-year Soeharto's government fell down and democratization started in 1998, the 1945 Constitution was not replaced with a new one, as seen in many other democratizing countries, but successively reformed to adapt itself to a new democratic regime. In the result of four constitutional amendments in 1999-2002, political institutions in Indonesia are experiencing a transformation from an authoritative structure, in which the executive branch monopolized power along with incompetent legislative and judicial branches, to a modern democratic structure, in which the legislative branch can maintain predominance over the executive. However, as observed that President Abdurrahman Wahid, the first president ever elected democratically in Indonesian history, was impeached after one and a half years in office, democratic politics under a new political institution has never been stable. 　　　Under the 1945 Constitution, how did authoritarian regimes maintain stability? Why can a democratic regime not achieve its stability? What did the two constitutional amendments in the process of democratization change? In the first place, how did the political institutions stipulated by the 1945 Constitution come out? Through answering the above questions, this chapter intends to survey the historical continuity and change of political institutions in Indonesia along with the 1945 Constitutions and to analyze impact of regime transformation on political institutions. First, we examine political institutions stipulated by the original 1945 Constitution as well as historical and philosophical origins of the constitution. Second, we search constitutional foundations in the 1945 Constitution that made it possible for Soekarno and Soeharto to establish and maintain authoritarian regimes. Third, we examine contents of constitutional amendments in the process of democratization since 1998. Fourth, we analyze new political dynamics caused by constitutional changes, looking at the impeachment process of President Abdurrahman Wahid. Finally, we consider tasks faced by Indonesia that seeks to establish a stable democracy.

In Memory of Dr. Ali Al-Gritly (1913-1982): His Views on Egypt's experience with Socialism

This essay reexamines the great contributions made by Dr. Ali Al-Gritly to Egypt. He was the finance minister for a short period at the beginning of the 1950s and later was appointed as chairman of the Bank of Alexandria. In 1966, he completed a book (Al-Gritly [1966 (1974)]) on the economic history of Egypt. However, the book was banned from publication due to irresistible circumstances. At that time, with Arab Socialism on the ascendance, his views on certain policies were not welcomed by the top political hierarchy. In 1974, the book was finally allowed to be published, and he wrote and published another book in 1977 (Al-Gritly [1977]) on the development of the Open Door Policy and the new economic policies accompanying it.

Gacaca and DDR : the disputable record of state-building in Rwanda

State-building is currently considered to be an indispensable process in overcoming state fragility: a condition characterized by frequent armed conflicts as well as chronic poverty. In this process, both the capacity and the legitimacy of the state are supposed to be enhanced; such balanced development of capacity and legitimacy has also been demanded in security sector reform (SSR), which is regarded as being a crucial part of post-conflict state-building. To enhance legitimacy, the importance of democratic governance is stressed in both state-building and SSR in post-conflict countries. In reality, however, the balanced enhancement of capacity and legitimacy has rarely been realized. In particular, legitimacy enhancement tends to stagnate in countries in which one of multiple warring parties takes a strong grip on state power. This paper tries to understand why such unbalanced development of state-building and SSR has been observed in post-conflict countries, through a case study of Rwanda. Analyses of two policy initiatives in the security sector - Gacaca transitional justice and disarmament, demobilization, and reintegration (DDR) - indicate that although these programs achieved goals set by the government, their contribution to the normative objectives promoted by the international community was quite debatable. It can be understood that this is because the country has subordinated SSR to its state-building process. After the military victory of the former rebels, the Rwandan Patriotic Front (RPF), the ruling elite prioritized the establishment of political stability over the introduction of international norms such as democratic governance and the rule of law. SSR was implemented only to the extent that it contributed to, and did not threaten, Rwanda's RPF-led state-building.

Traffic uncertainty in toll motorway concessions in Spain

This study assessed the inaccuracy of the traffic estimates for toll motorway concessions in Spain. It was found that the estimates conducted by both the government and the concessionaire showed a significant bias towards overestimating traffic. The level of overestimation in Spain is even greater than that reported by other studies based on worldwide data. The notorious levels of overestimation entail severe burdens to the economics of the concessionaires that often prompt renegotiations of the contracts, which are often accepted by the government. These renegotiations usually end up with toll changes or extension of the concession terms, which have to be ultimately borne by future motorway users. It is postulated herein that the bias towards overestimating traffic in toll motorways in Spain is mostly caused by strategic issues rather than by modelling errors.

PROFILE AND THE QUALITY OF LIFE OF LOGGERS

RESUMO – Objetivou-se com este estudo caracterizar o perfil e avaliar o nível de satisfação que reflete na qualidade de vida no trabalho (QVT) de trabalhadores da colheita de madeira de duas contratadas (C1 e C2), por duas grandes empresas do setor florestal, sendo uma do segmento de papel e celulose (PC) e, a outra, do segmento de carvão vegetal (CV). A avaliação ocorreu a partir da percepção dos trabalhadores das contratadas em questão, utilizando um modelo pré-concebido que contempla 11 blocos ou dimensões referentes a variáveis intervenientes e definidores da QVT, englobando 48 trabalhadores em três categorias funcionais: operador de motosserra (7 trabalhadores da C1 PC e 10 da C2 CV), ajudante de motosserrista (7 trabalhadores da C1 PC e 8 da C2 CV) e operador de carregador florestal (11 trabalhadores da C1 PC e 5 da C2 CV). Os dados referentes às variáveis intervenientes na QVT foram obtidos a partir de escala fechada do tipo Likert, com os escores variando de 1 a 7, em que 1 correspondeu ao nível "bastante insatisfeito" e 7, ao nível "bastante satisfeito". O perfil dos trabalhadores é de pessoa jovem, baixo nível de escolaridade e pouco tempo de serviço na empresa. Quanto ao nível de satisfação no trabalho, constatou-se que os trabalhadores da C1 PC se encontravam "satisfeitos" e os da C2 CV, "mediamente satisfeitos" com o trabalho e as condições proporcionadas pelas respectivas empresas, apesar de estatisticamente não ter sido detectada diferença entre os valores médios encontrados nas duas situações, pelo teste de Mediana (P>0,01). Os fatores que mais contribuíram para esses resultados favoráveis foram os benefícios extras oferecidos pelas prestadoras de serviços, as condições de segurança no trabalho e o contentamento com o emprego formal. ABSTRACT – The objective of this study was to characterize profile and satisfaction level, which reflects the quality of life (QOL) of forest workers of two contracts for harvest activities, one in the pulp and paper industry (PI) and another in charcoal industry (CI). The evaluation of the satisfaction indexes was carried out according to the workers perception by using a model including 11 parameters to reflect these workers QOL. The group study of 48 workers encompassed three functional categories: chainsaw operators (7 from C1 and 10 from C2), chainsaw operator's assistant (7 from C1 and 8 from C2), and log loader operators (11 from C1 and 5 from C2). Data regarding the factors involved in QOL were collected from a closed, Likert-type scale with scores ranging from 1-7, in which level 1 corresponded to "very dissatisfied" and level 7 to "very satisfied". The general profile of the group shows that most of them are young, with low level of education and employed in the companies for a short time. Overall, the employees of contractors of the paper and pulp industry are "satisfied" and those working for the charcoal company are only "moderately satisfied" with the work and policies offered by the respective companies, although no significant statistical difference was detected between the two groups, for the median test (P> 0.01). The main reasons behind these results are the general beneficts offered by the companies, the safety measurements and the overall satisfaction for been employed.

Effectiveness of safety-based incentives in Public Private Partnerships: Evidence from the case of Spain

Many countries around the world are implementing Public?Private?Partnership (PPP) contacts to manage road infrastructure. In some of these contracts the public sector introduces economic incentives to the private operator to foster the accomplishment of social goals. One of the incentives that have been introduced in some PPP contracts is related to safety in such a way that the better the safety outcome the greater will be the economic reward to the contractor. The aim of this paper is at identify whether the incentives to improve road safety in highway PPPs are ultimately effective in improving safety ratios. To this end Poisson and negative binomial regression models have been applied using information from highway sections in Spain. The findings indicate that even though road safety is highly influenced by variables that are not much controllable by the contractor such as the Average Annual Daily Traffic and the percentage of heavy vehicles, the implementation of safety incentives in PPPs has a positive influence in the reduction of fatalities, injuries and accidents.

Water option contracts for reducing water supply risks: an application to the Tagus-Segura Transfer

El agua es un recurso cada vez más escaso y valioso. Por ello, los recursos hídricos disponibles deben asignarse de una forma eficiente entre los diferentes usos. El cambio climático aumentará la frecuencia y severidad de los eventos extremos, y podría incrementar la demanda de agua de los cultivos. El empleo de mecanismos flexibles de asignación de agua puede ser imprescindible para hacer frente a este aumento en la variabilidad del balance hídrico y para asegurar que los riesgos de suministro, y no solo los recursos, son compartidos de manera eficiente entre los usuarios. Los mercados de agua permiten la reasignación de los recursos hídricos, favoreciendo su transferencia desde los usos de menor a los de mayor valor. Diferentes tipos de mercados de agua se han establecido en diferentes partes del mundo, ayudando a los participantes a afrontar los problemas de escasez de agua en esas zonas. En España, los intercambios de agua están permitidos desde 1999, aunque la participación de los usuarios en el mercado ha sido limitada. Hay varios aspectos de los mercados de agua en España que deben mejorarse. Esta tesis, además de proponer una serie de cambios en el marco regulatorio, propone la introducción de contratos de opción de agua como una posible mejora. La principal ventaja de este tipo de contratos es la estabilidad legal e institucional que éstos proporcionan tanto a compradores como vendedores. Para apoyar esta propuesta, se han llevado a cabo diferentes análisis que muestran el potencial de los contratos de opción como herramienta de reducción del riesgo asociado a una oferta de agua inestable. La Cuenca del Segura (Sureste de España), la Cuenca del Tajo y el Acueducto Tajo- Segura han sido seleccionados como casos de estudio. Tres análisis distintos aplicados a dicha región se presentan en esta tesis: a) una evaluación de los contratos de opción como mecanismo para reducir los riesgos de disponibilidad de agua sufridos por los regantes en la Cuenca del Segura; b) un marco teórico para analizar las preferencias de los regantes por diferentes mecanismos de gestión del riesgo de disponibilidad de agua, su disposición a pagar por ellos y los precios aproximados de estos instrumentos (seguro de sequía y contratos de opción de agua); y c) una evaluación del papel de los contratos de opción en las decisiones de aprovisionamiento de agua de una comunidad de regantes ante una oferta de agua incierta. Los resultados muestran el potencial de reducción del riesgo de los contratos de opción para regantes en España, pero pueden ser extrapolados a otros sectores o regiones. Las principales conclusiones de esta tesis son: a) la agricultura será uno de los sectores más afectados por el cambio climático. Si los precios del agua aumentan, la rentabilidad de los cultivos puede caer hasta niveles negativos, lo que podría dar lugar al abandono de cultivos de regadío en algunas zonas de España. Las políticas de cambio climático y de agua deben estar estrechamente coordinadas para asegurar un uso de agua eficiente y la rentabilidad de la agricultura; b) aunque los mercados de agua han ayudado a algunos usuarios a afrontar problemas de disponibilidad del recurso en momentos de escasez, hay varios aspectos que deben mejorarse; c) es necesario desarrollar mercados de agua más flexibles y estables para garantizar una asignación eficiente de los recursos entre los usuarios de agua; d) los resultados muestran los beneficios derivados del establecimiento de un contrato de opción entre usuarios de agua del Tajo y del Segura para reducir el riesgo de disponibilidad de agua en la cuenca receptora; e) la disposición a pagar de los regantes por un contrato de opción de agua o un seguro de sequía hidrológica, que representa el valor que tienen estos mecanismos para aquellos usuarios de agua que se enfrentan a riesgos relacionados con la disponibilidad del recurso, es consistente con los resultados obtenidos en estudios previos y superior al precio de mercado de estos instrumentos, lo que favorece la viabilidad de estos mecanismos de gestión del riesgo ; y f) los contratos de opción podrían ayudar a optimizar las decisiones de aprovisionamiento de agua bajo incertidumbre, proporcionando más estabilidad y flexibilidad que los mercados temporales de agua. ABSTRACT Water is becoming increasingly scarce and valuable. Thus, existing water resources need to be efficiently allocated among users. Climate change is expected to increase the frequency and severity of extreme events, and it may also increase irrigated crops' water demand. The implementation of flexible allocation mechanisms could be essential to cope with this increased variability of the water balance and ensure that supply risks, and not only water resources, are also efficiently shared and managed. Water markets allow for the reallocation of water resources from low to high value uses. Different water trading mechanisms have been created in different parts of the world and have helped users to alleviate water scarcity problems in those areas. In Spain, water trading is allowed since 1999, although market activity has been limited. There are several issues in the Spanish water market that should be improved. This thesis, besides proposing several changes in the legislative framework, proposes the introduction of water option contracts as a potential improvement. The main advantage for both buyer and seller derived from an option contract is the institutional and legal stability it provides. To support this proposal, different analyses have been carried out that show the potential of option contracts as a risk reduction tool to manage water supply instability. The Segura Basin (Southeast Spain), the Tagus Basin and the Tagus-Segura inter-basin Transfer have been selected as the case study. Three different analyses applied to this region are presented in this thesis: a) an evaluation of option contracts as a mechanisms to reduce water supply availability risks in the Segura Basin; b) a theoretical framework for analyzing farmer’s preferences for different water supply risk management tools and farmers’ willingness to pay for them, together with the assessment of the prices of these mechanisms (drought insurance and water option contracts); and c) an evaluation of the role of option contracts in water procurement decisions under uncertainty. Results show the risk-reduction potential of option contracts for the agricultural sector in Spain, but these results can be extrapolated to other sectors or regions. The main conclusions of the thesis are: a) agriculture would be one of the most affected sectors by climate change. With higher water tariffs, crop’s profitability can drop to negative levels, which may result in the abandoning of the crop in many areas. Climate change and water policies must be closely coordinated to ensure efficient water use and crops’ profitability; b) although Spanish water markets have alleviated water availability problems for some users during water scarcity periods, there are several issues that should be improved; c) more flexible and stable water market mechanisms are needed to allocate water resources and water supply risks among competing users; d) results show the benefits derived from the establishment of an inter-basin option contract between water users in the Tagus and the Segura basins for reducing water supply availability risks in the recipient area; e) irrigators’ willingness to pay for option contracts or drought insurance, that represent the value that this kind of trading mechanisms has for water users facing water supply reliability problems, are consistent with results obtained in previous works and higher than the prices of this risk management tools, which shows the feasibility of these mechanisms; and f) option contracts would help to optimize water procurement decisions under uncertainty, providing more flexibility and stability than the spot market.

Formulación de incentivos óptimos y viables para la mejora de la seguridad vial en concesiones de carreteras

La evolución de los roles de la Administración y empresas en la prestación de servicios públicos, así como las crecientes restricciones presupuestarias para financiarlos, están propiciando una cada vez mayor utilización del sistema concesional para la financiación y gestión de carreteras. Ante esta situación, cabe cuestionarse si la regulación de las prestaciones a obtener se está introduciendo de forma adecuada en los contratos. Uno de los aspectos más relevantes en este sentido es el relacionado con la seguridad de la infraestructura, sobre el cual la empresa concesionaria tiene capacidad de actuación pero, en un sentido económico estricto, pocos incentivos para mejorarla. Todo ello a pesar de los elevados costes sociales derivados de la accidentalidad. Esta tesis analiza la idoneidad de los indicadores e incentivos de seguridad vial que se vienen aplicando en concesiones de carreteras, encontrándose una gran heterogeneidad e incluso incorrecciones técnicas en su formulación. Además se pone de manifiesto la poca vinculación que tienen con la estructura de costes y beneficios de las actuaciones de mejora de seguridad vial, por lo que su introducción en los contratos resulta anodina. Con el objeto de superar esta situación, en esta tesis se analizan en profundidad los aspectos que intervienen en la formulación de indicadores e incentivos de seguridad vial. De este análisis se deduce la ecuación que liga, por tipología de carretera, el beneficio social derivado del nivel de seguridad de la carretera y el coste para alcanzarlo. A través de esta ecuación se determina el nivel de seguridad óptimo desde el punto de vista económico‐social. La investigación continúa extrapolando métodos de la teoría microeconómica de incentivos al campo de las concesiones de carreteras, a fin de determinar la formulación del incentivo de seguridad vial teóricamente óptimo. Asimismo, la tesis toma en consideración la experiencia en la aplicación práctica de incentivos en concesiones vigentes, realizándose una propuesta para superar las controversias que se están produciendo actualmente en España. Además, se ha simulado la aplicación de la formulación propuesta a diversas concesiones con un doble objetivo: verificar la viabilidad económica de su aplicación y corroborar en qué medida se adecua mejor al óptimo económico‐social. Como resultado, se proponen un indicador y un incentivo concretos que inducen a las concesionarias a orientar su gestión hacia la consecución del nivel de seguridad vial óptimo desde el punto de vista económico‐social, todo ello dentro de un marco de viabilidad presupuestaria. Changes in the roles of Government and the Private Sector in the provision of public services along with the budget constraints to finance them are resulting in an increasing use of the concession system for financing and managing roads. Taking this into account, the question is whether the regulation of quality criteria is being properly introduced in the contracts or not. One of the most important aspects at this respect is the road safety. On the one hand, concessionaires are able to manage this aspect up to a point. On the other hand, from an strict economic point of view, they have little incentive to improve it, despite the high social costs of accidents. This thesis has analyzed the suitability of indicators and incentives usually introduced in road concession contracts, finding high heterogeneity, and even technical inaccuracies on their formulation. It has also been found the lack of connection between these incentives and the costs of measures to improve road safety, therefore they are not expected to fulfil their purpose. In order to overcome this situation, this thesis firstly analyzes in depth the issues involved in the development of road safety indicators and incentives. This analysis yields the equation which links the social benefit derived from the level of road safety and the cost to achieve it. In its turn, through this equation it is possible to meet the optimal road safety level from the socio‐economic point of view. Secondly, this thesis extrapolates microeconomic methods to the field of highway concessions, with the aim of determining the formulation of the optimal road safety incentive. Furthermore, the thesis takes into account the experience in the practical application of incentives on existing concessions, performing a proposal to settle the disputes between concessionaires and the Public Administrations. Finally, the thesis simulates the implementation of the proposed indicator and incentive to real concessions with the aim of verifying the economic feasibility of their application and confirming how they match the socio‐economic optimum. As a result, this thesis proposes an indicator and incentive that induce companies to drive the management of the concession towards achieving the optimal road safety level, all within a framework of the budgetary feasibility.

Concept and measurement: the cultural borders of meaning

Paper submitted to the Sixth International Conference on Social Science Methodology, Amsterdam, The Netherlands, August 16-20, 2004.

Alterations in energy metabolism, neuroprotection and visual signal transduction in the retina of parkinsonian, MPTP-treated monkeys

Parkinson disease is mainly characterized by the degeneration of dopaminergic neurons in the central nervous system, including the retina. Different interrelated molecular mechanisms underlying Parkinson disease-associated neuronal death have been put forward in the brain, including oxidative stress and mitochondrial dysfunction. Systemic injection of the proneurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to monkeys elicits the appearance of a parkinsonian syndrome, including morphological and functional impairments in the retina. However, the intracellular events leading to derangement of dopaminergic and other retinal neurons in MPTP-treated animal models have not been so far investigated. Here we have used a comparative proteomics approach to identify proteins differentially expressed in the retina of MPTP-treated monkeys. Proteins were solubilized from the neural retinas of control and MPTP-treated animals, labelled separately with two different cyanine fluorophores and run pairwise on 2D DIGE gels. Out of >700 protein spots resolved and quantified, 36 were found to exhibit statistically significant differences in their expression levels, of at least ±1.4-fold, in the parkinsonian monkey retina compared with controls. Most of these spots were excised from preparative 2D gels, trypsinized and subjected to MALDI-TOF MS and LC-MS/MS analyses. Data obtained were used for protein sequence database interrogation, and 15 different proteins were successfully identified, of which 13 were underexpressed and 2 overexpressed. These proteins were involved in key cellular functional pathways such as glycolysis and mitochondrial electron transport, neuronal protection against stress and survival, and phototransduction processes. These functional categories underscore that alterations in energy metabolism, neuroprotective mechanisms and signal transduction are involved in MPTPinduced neuronal degeneration in the retina, in similarity to mechanisms thought to underlie neuronal death in the Parkinson’s diseased brain and neurodegenerative diseases of the retina proper.

Information systems contracts and relationships: A Spanish perspective

Despite the proliferation of academic research on information systems outsourcing, not many studies analyze the characteristics of outsourcing contracts. This research aims to provide an in-depth description of information systems outsourcing. An additional objective is to examine how these characteristics evolve over time. Finally, this study reports on the usefulness of measuring such characteristics over time to assess the maturity level of the information systems outsourcing. This study gathers the data from the responses of the information systems managers of the largest Spanish firms to a questionnaire. This longitudinal study covers 12 years of research and compares authors' previous research results with the results of this study.

Map of the Indus River and the neighbouring countries: comprising Sind, parts of Beloochistan and Afghanistan, Cashmeer, Punjab, Bhawulpoor, the protected Sikh States, Bickaneer and Jaysulmeer; & the Western Parts of Rajpootana

compiled by order of Government in the Office of the Surveyor General of India [Geo. Everest] from authentic and recent materials April 1834 by J. Graham ; drawn by Ed. Winston and D. F. Chill.