Eye Care Service in Scotland: Did the Scots Get it Right?

In March 2004, the Scottish government announced a review of eye care services in Scotland, which culminated in the introduction of free eye examinations from 1st April 2006. This free eye examination is not just a sight test; it is a thorough examination to check the health of the patient’s eyes and to look for signs of other health problems. The Scottish government commissioned private ophthalmic optician practices to perform these eye examinations. Consequently, since April 2006 individuals in Scotland could walk into any high street optometry practice and get a ‘free’ eye examination funded under the NHS.

Prise en charge par une équipe pluridisciplinaire des patients avec multiples vulnérabilités dans un service d'urgence

Introduction: Les centres d'urgence se trouvent régulièrement confrontés à des patients avec de multiples vulnérabilités médico-sociales qui recourent préférentiellement aux urgences pour y recevoir des soins de bases. Leurs fréquentes consultations contribuent à encombrer les urgences : dans notre service d'urgence entre avril 2008 et mars 2009, une étude ayant pour but de caractériser ces patients a montré que 14 % de l'ensemble des consultations ont été causées par 5 % des patients admis > 4 x/an.Matériel et méthode: Cohorte prospective des patients admis aux urgences et présentant des critères touchant > 3 axes de vulnérabilités sur les 5 axes reconnus habituellement (déterminants somatiques, de santé mentale, comportemental, social, de consommation de soins). Les patients inclus ont été soit signalés par le personnel médico-infirmier des urgences, soit dépistés par une équipe pluridisciplinaire (2 infirmières, 1 assistant social, 1 médecin) durant les jours ouvrables du 1.9.2010 au 14.12.2010.Résultats: 75 patients ont été inclus (65 % d'hommes). La moyenne d'âge était de 43 ans. 59 % étaient des migrants en provenance de : Europe (22 %), Afrique (22 %), Asie (12 %), Amériques du Sud (6 %) et du Nord (1 %). Les vulnérabilités les plus fréquentes étaient: somatiques 76 % (maladies aiguës/chroniques sévères 50 %, mauvaise adhérence thérapeutique 40 %), liées à la santé mentale 65 % (troubles anxieux et dépressifs 54 %), comportementales 80 % (addictions aux substances 73 %), sociales 93 % (absence de domicile fixe 31 %, absence d'assurance-maladie 15 %, barrières linguistiques 24 %, à l'assistance sociale 46 %) et consommation de soins (> 4 visites aux urgences/an 57 %, absence de médecin de premier recours 33 %). La charge de travail moyenne pour orienter ces patients vers des structures de santé primaire était de 3 heures/cas. Les interventions ont été d'évaluer le réseau de soins déjà impliqué (98 %), de réorienter dans le réseau ambulatoire (64 %) ou vers les services sociaux (37 %).Conclusion: Les vulnérabilités multiples sont relativement peu fréquentes dans notre service d'urgence mais leur complexité requiert des ressources qui dépassent ce que peuvent offrir des équipes de soins habituelles aux urgences. Une prise en charge individuelle par une équipe pluridisciplinaire est susceptible de fournir ces ressources et de réorienter ces patients vers des structures ambulatoires adaptées à leurs besoins.

Scheduled Service Versus Personal Transportation: The Role of Distance

This paper presents a theoretical and empirical analysis of the relationship be- tween frequency of scheduled transportation services and their substitutability with personal transportation (using distance as a proxy). We study the interaction between a monopoly firm providing a high-speed scheduled service and private transportation (i.e., car). Interestingly, the carrier chooses to increase the frequency of service on longer routes when competing with personal transportation because by providing higher frequency (at extra cost) it can also charge higher fares which can boost its profits. However, in line with the results of earlier studies, frequency decreases for longer flights when driving is not a viable option. An empirical application of our analysis to the European airline industry confirms the predictions of our theoretical model. Keywords: short-haul routes; long-haul routes; flight frequency; distance JEL Classification Numbers: L13; L2; L93

Service offshoring and white-collar employment

This paper empirically studies the effects of service offshoring on white-collar employment, using data for more than one hundred U.S. occupations. A model of firm behavior based on separability allows to derive the labor demand elasticity with respect to service offshoring for each occupation. Estimation is performed with Quasi-Maximum Likelihood, to account for high degrees of censoring in the employment variable. The estimated elasticities are then related to proxies for the skill level and the degree of tradability of the occupations. Results show that service offshoring increases high skilled employment and decreases medium and low skilled employment. Within each skill group, however, service offshoring penalizes tradable occupations and benefits non-tradable occupations.

The antecedents and innovation consequences of organizational search: empirical evidence for Spain

This paper examines the antecedents and innovation consequences of the methods firms adopt in organizing their search strategies. From a theoretical perspective, organizational search is described using a typology that shows how firms implement exploration and exploitation search activities that span their organizational boundaries. This typology includes three models of implementation: ambidextrous, specialized, and diversified implementation. From an empirical perspective, the paper examines the performance consequences when applying these models, and compares their capacity to produce complementarities. Additionally, since firms' choices in matters of organizational search are viewed as endogenous variables, the paper examines the drivers affecting them and identifies the importance of firms' absorptive capacity and diversified technological opportunities in determining these choices. The empirical design of the paper draws on new data for manufacturing firms in Spain, surveyed between 2003 and 2006.

Innovation sources and productivity in Catalonian firms: a quantile regression analysis

This paper explores the effects of two main sources of innovation - intramural and external R&D— on the productivity level in a sample of 3,267 Catalonian firms. The data set used is based on the official innovation survey of Catalonia which was a part of the Spanish sample of CIS4, covering the years 2002-2004. We compare empirical results by applying usual OLS and quantile regression techniques both in manufacturing and services industries. In quantile regression, results suggest different patterns at both innovation sources as we move across conditional quantiles. The elasticity of intramural R&D activities on productivity decreased when we move up the high productivity levels both in manufacturing and services sectors, while the effects of external R&D rise in high-technology industries but are more ambiguous in low-technology and knowledge-intensive services. JEL codes: O300, C100, O140 Keywords: Innovation sources, R&D, Productivity, Quantile Regression

General Practitioners' willingness to pay for continuing medical education in a fee-for-service universal coverage health care system

Background: Sponsoring of physicians meetings by life science companies has led to reduced participation fees but might influence physician's prescription practices. A ban on such sponsoring may increase participation fees. We aimed to evaluate factors associated with physicians' willingness to pay for medical meetings, their position on the sponsoring of medical meetings and their opinion on alternative financing options. Methods: An anonymous web-based questionnaire was sent to 447 general practitioners in one state in Switzerland, identified through their affiliation to a medical association. The questionnaire evaluated physicians' willingness to pay for medical meetings, their perception of a bias in prescription practices induced by commercial support, their opinion on the introduction of a binding legislation and alternative financing options, their frequency of exchange with sales representatives and other relevant socioeconomic factors. We built a multivariate predictor logistic regression model to identify determinants of willingness to pay. Results: Of the 115 physicians who responded (response rate 26%), 48% were willing to pay more than what they currently pay for congresses, 79% disagreed that commercial support introduced a bias in their prescription practices and 61% disagreed that it introduced a bias in their colleagues' prescription practices. Based on the multivariate logistic regression, perception of a bias in peers prescription practices (OR=7.47, 95% CI 1.65-38.18) and group practice structure (OR=4.62, 95% CI 1.34-22.29) were significantly associated with an increase in willingness to pay. Two thirds (76%) of physicians did not support the introduction of a binding legislation and 53% were in favour of creating a general fund administered by an independent body. Conclusion: Our results suggest that almost half of physicians surveyed are willing to pay more than what they currently pay for congresses. Predictors of an increase in physicians' willingness to pay were perception of the influence of bias in peers prescription practices and group practice structure. Most responders did not agree that sponsoring introduced prescribing bias nor did they support the 2 introduction of a binding legislation prohibiting sponsoring but a majority did agree to an independent body that would centrally administer a general fund.

Public policy for entrepreneurship and innovation: impact in managed and entrepreneurial economies

Many of the most advanced economies of the world have undergone significant transformation in the last few decades. Globalization and technological changes, especially developments in information technologies, have helped to stimulate this transformation. These have contributed to changing institutional frameworks in many respects within the economies including adjustments to economic policies. The results of these transformations take many different forms and are manifested in different areas of an economy. At the heart of these changes however, has been the increasingly important role of entrepreneurship in the economy. The transformed ("new") economy stimulates and supports activities in innovation and entrepreneurship and is labelled the entrepreneurial economy. The "old" economy on the other hand restricts such activities and is referred to as the managed economy (Audretsch & Thurik, 2001).

Gestión sostenible de clústers de recursos virtuales

Este proyecto tiene como finalidad ofrecer un servicio de computación en forma de máquina virtual, utilizando los recursos internos de Atos Research & Innovation. Además, se pretende implementar este servicio sobre os excendentes de máquinas del propio departamento. La prestación de este servicio se realiza mediante un gestor de la infraestructura de forma centralizada. Para la implantación de este entorno se ha definido la adopción en fases y profundizado en dos de los gestores más activos en la investigación del modelo Cloud Computing (Open Nebula, Eucalyptus).

Analysing the innovation process in the EU Integrated Programme, ISAFRUIT

ISAFRUIT is an integrated European Union Project focussed on increasing fruit consumption as a means to improve human health, through evaluating the fruit chain and addressing bottlenecks therein.The innovations which are being developed throughout the ISAFRUIT Project have been analysed to determine both the success factors and the obstacles in reaching the commercialisation stage. Only 9.58% of the deliverables planned within the Project were focussed on developing technological innovations.There is evidence, however, of successes in the development of new innovations arising from the ISAFRUIT Project, with several other potential innovations in the pipeline. Of the technologies identified, 67% are still at the “invention stage”; that is, the stage prior to bridging the so-called “valley of death”, the stage between an invention and an innovation. Those which are considered to have moved over the “valley of death” either had industry partners included in the Project, or had consulted with industry to ensure that the technology was relevant, or met a recognised industry need. Many of the technologies which made less progress did not have the same interactions with industry. A number of other issues were identified which prevented further progress towards innovation. The need for scientists to publish scientific papers, both for their career pathways and to increase their chances of future funding, was identified as one issue, although the filing of patents is now becoming more accepted and recognised. The patenting system is considered complex by many scientists and is not well-understood. Finally, agreements between partners on the sharing of intellectual property rights can cause a delay in the innovation process.

Employment effects of service offshoring: evidence from matched firms

This paper studies the effects of service offshoring on the level and skill composition of domestic employment, using a rich data set of Italian firms and propensity score matching techniques. The results show that service offshoring has no effect on the level of employment but changes its composition in favor of high skilled workers.