La governance del sociosanitario in Emilia Romagna: Esperienze e prospettive

In un contesto dominato da invecchiamento della popolazione, prevalenza della cronicità e presenza crescente di pazienti multiproblematici e non autosufficienti è indispensabile spostare il baricentro delle cure dall'acuzie alla cronicità, e quindi assicurare la continuità e la coerenza fra i diversi setting di cura, sia sanitari che socio-sanitari (ospedale, servizi sanitari territoriali, domicilio, strutture residenziali di Long term care). Dall'analisi della letteratura emerge che il maggiore ostacolo a realizzare questa continuità è rappresentato dalla presenza, caratteristica del sistema di welfare italiano, di molteplici attori e strutture con competenze, obiettivi e funzioni diverse e separate, e la raccomandazione di lavorare per l'integrazione contemporaneamente su più livelli: - normativo-istituzionale - programmatorio - professionale e gestionale Il sistema della "governance" realizzato in Emilia-Romagna per l'integrazione socio-sanitaria è stato valutato alla luce di queste raccomandazioni, seguendo il modello della Realist evaluation per i Social complex interventions: enucleando le "teorie" alla base dell'intervento ed analizzando i diversi step della sua implementazione. Alla luce di questa valutazione, il modello della "governance" è risultato coerente con le indicazioni delle linee guida, ed effettivamente capace di produrre risultati al fine della continuità e della coerenza fra cure sanitarie e assistenza sociale e sanitaria complessa. Resta da realizzare una valutazione complessiva dell'impatto su efficacia, costi e soddisfazione dei pazienti.

Rural governance and livelihoods systems diversification in the Western Balkans: comparative case studies of Bosnia and Herzegovina, Montenegro and Serbia

Agriculture is still important for socio-economic development in rural areas of Bosnia, Montenegro and Serbia (BMS). However, for sustainable rural development rural economies should be diversified so attention should be paid also to off-farm and non-farm income-generating activities. Agricultural and rural development (ARD) processes and farm activity diversification initiatives should be well governed. The ultimate objective of this work is to explore linkages between ARD governance and rural livelihoods diversification in BMS. The thesis is based on an extended secondary data analysis and surveys. Questionnaires for ARD governance and coordination were sent via email to public, civil society and international organizations. Concerning rural livelihood diversification, the field questionnaire surveys were carried out in three rural regions of BMS. Results show that local rural livelihoods are increasingly diversified but a significant share of households are still engaged in agriculture. Diversification strategies have a chance to succeed taking into consideration the three rural regions’ assets. However, rural households have to tackle many problems for developing new income-generating activities such as the lack of financial resources. Weak business skills are also a limiting factor. Fully exploiting rural economy diversification potential in BMS requires many interventions including improving rural governance, enhancing service delivery in rural areas, upgrading rural people’s human capital, strengthening rural social capital and improving physical capital, access of the rural population to finance as well as creating a favourable and enabling legal and legislative environment fostering diversification. Governance and coordination of ARD policy design, implementation and evaluation is still challenging in the three Balkan countries and this has repercussions also on the pace of rural livelihoods diversification. Therefore, there is a strong and urgent need for mobilization of all rural stakeholders and actors through appropriate governance arrangements in order to foster rural livelihoods diversification and quality of life improvement.

Regulating State Aid: Inter-jurisdictional competition, public choice, and corporate governance

Depending on the regulatory regime they are subject to, governments may or may not be allowed to hand out state aid to private firms. The economic justification for state aid can address several issues present in the competition for capital and the competition for transfers from the state. First, there are principal-agent problems involved at several stages. Self-interested politicians might enter state aid deals that are the result of extensive rent-seeking activities of organized interest groups. Thus the institutional design of political systems will have an effect on the propensity of a jurisdiction to award state aid. Secondly, fierce competition for firm locations can lead to over-spending. This effect is stronger if the politicians do not take into account the entirety of the costs created by their participation in the firm location race. Thirdly, state aid deals can be incomplete and not in the interest of the citizens. This applies if there are no sanctions if firms do not meet their obligations from receiving aid, such as creating a certain number of jobs or not relocating again for a certain amount of time. The separation of ownership and control in modern corporations leads to principal-agent problems on the side of the aid recipient as well. Managers might receive personal benefits from subsidies, the use of which is sometimes less monitored than private finance. This can eventually be to the detriment of the shareholders. Overall, it can be concluded that state aid control should also serve the purpose of regulating the contracting between governments and firms. An extended mandate for supervision by the European Commission could include requirements to disincentive the misuse of state aid. The Commission should also focus on the corporate governance regime in place in the jurisdiction that awards the aid as well as in the recipient firm.

The Influence of Direct Democracy on Agency Costs: Lessons from Corporate Governance

This dissertation seeks to improve the usage of direct democracy in order to minimize agency cost. It first explains why insights from corporate governance can help to improve constitutional law and then identifies relevant insights from corporate governance that can make direct democracy more efficient. To accomplish this, the dissertation examines a number of questions. What are the key similarities in corporate and constitutional law? Do these similarities create agency problems that are similar enough for a comparative analysis to yield valuable insights? Once the utility of corporate governance insights is established, the dissertation answers two questions. Are initiatives necessary to minimize agency cost if referendums are already provided for? And, must the results of direct democracy be binding in order for agency cost to be minimized?

The Road to Poverty Reduction: Corporate Governance and Female Participation in MFIs

1.Microfinance Industry – Context of Analysis. This paper is an introduction to the microfinance industry. It serves as a context of analysis, for the empirical settings and basis for building the theoretical argument for the thesis. 2.Women in Microfinance Institutions: The Road to Poverty Reduction and Gender Equality? One of the unique aspects of microfinance institutions is their focus on outreach, i.e. their ability to reach the poor. This paper explores whether the presence of women in microfinance institutions is associated with improved outreach. Building on prior research that shows that women tend to improve financial performance and social responsibility, we examine an original dataset of 226 microfinance institutions. The empirical results suggest that the presence of a female CEO, female managers and female loan officers is directly related to improved outreach, while the presence of women board members is not. 3. Women in Microfinance Institutions: Is There a Trade-Off Between Outreach and Sustainability? Abstract This paper’s contribution to the understanding of microfinance is two-fold. First, while it has been shown that female CEOs in MFIs increase financial performance, it will be argued that female managers, female loan officers and female board members will do the same. Secondly, having previously shown that having a female presence in management in MFIs improves social performance the outreach, it will be argued that having females in the MFIs’ management will not lead to a trade-off between outreach and sustainability. These findings are based on an original data set of 226 MFIs. Statistical analysis demonstrates that a weak relationship between female managers and female loan officers vis-à-vis financial performance, but female board members do not. The trade-off between outreach and sustainability can be avoided with the appointment of females to the MFIs’ management positions, but the same cannot be concluded for female board members.

Internet Governance: problematiche e prospettive della nuova frontiera del Diritto Informatico

Questa tesi si propone di mettere in evidenza la forte spinta innovatrice che internet potrebbe dare allo sviluppo della democrazia, avendo abbattuto in maniera brutale i confini geo-politici, democratizzato addirittura all'esasperazione la libertà di parola e la possibilità di ognuno di far sentire la propria opinione ad un pubblico globale, rendendo sterile qualsivoglia regolamentazione locale e creando nuove e importanti problematiche di portata universale. Sulla rete viaggiano senza soluzione di continuità dati di ogni tipo, si concretizzano transazioni, si intrecciano relazioni, il tutto sorpassando agilmente le barriere fisiche dei confini nazionali, la distanza, le leggi, mettendo quindi l’umanità di fronte alla nuova sfida di armonizzare i vari ordinamenti giuridici, superare il concetto di sovranità nazionale e di creare un meccanismo democratico e partecipato di gestione della rete. La extraterritorialità della rete e il fatto che non si possa qualificare un "popolo sovrano" appartenente a questa entità, ha come vedremo posto l’umanità di fronte a nuove e ardue sfide: la necessità di regolare un mezzo così potente e diffuso ha portato negli anni ad un lungo dibattito, che vedremo, e che pone questioni di importanza capitale per la società di oggi così come la conosciamo: "si può esigere che l’evoluzione tecnologica della rete sia orientata al raggiungimento di obiettivi di interesse pubblico?", "chi deve gestire la rete?", "usufruire di internet è un diritto della persona?", "chi è il soggetto che ha possibilità e facoltà di intervenire efficacemente per la normazione della rete? I privati, lo Stato, gli utenti, o è necessario un quadro concertato che consideri tutti i pareri e gli interessi sulla questione?".