Mixed Public-Private Enterprises in Europe: Economic Theory and an Empirical Analysis of Italian Water Utilities. Bruges European Economic Research (BEER) Papers 4/July 2006

Mixed enterprises, which are entities jointly owned by the public and private sector, are spreading all over Europe in local utilities. Well aware that in the vast majority of cases the preference of local authorities towards such governance structure is determined by practical reasons rather than by the ambition to implement new regulatory designs (an alternative to the typical “external” regulation), our purpose is to confer some scientific value to this phenomenon which has not been sufficiently investigated in the economic literature. This paper aims at proposing an economic analysis of mixed enterprises, especially of the specific configuration in which the public partner acts as controller and the private one (or “industrial” partner) as service provider. We suggest that the public service concession to mixed enterprises could embody, under certain conditions, a noteworthy substitute to the traditional public provision and the concession to totally private enterprises, as it can push regulated operators to outperform and limit the risk of private opportunism. The starting point of the entire analysis is that ownership allows the (public) owner to gather more information about the actual management of the firm, according to property rights theory. Following this stream of research, we conclude that under certain conditions mixed enterprises could significantly reduce asymmetric information between regulators and regulated firms by implementing a sort of “internal” regulation. With more information, in effect, the public authority (as owner/controller of the regulated firm, but also as member of the regulatory agency) can stimulate the private operator to be more efficient and can monitor it more effectively with respect to the fulfilment of contractual obligations (i.e., public service obligations, quality standards, etc.). Moreover, concerning the latter function, the board of directors of the mixed enterprise can be the suitable place where public and private representatives (respectively, welfare and profit maximisers) can meet to solve all disputes arising from incomplete contracts, without recourse to third parties. Finally, taking into account that a disproportionate public intervention in the “private” administration (or an ineffective protection of the general interest) would imply too many drawbacks, we draw some policy implications that make an equitable debate on the board of the firm feasible. Some empirical evidence is taken from the Italian water sector.

Economic and climate change pressures on biodiversity in southern Mediterranean coastal areas. MEDPRO Technical Report No. 24/February 2013

This paper establishes and measures key biodiversity and ecosystem health indicators and the number of world heritage sites in coastal areas at global level. It then estimates – econometrically – the indicators’ influence on the provision of tourism values through the marine ecosystem function as a harbour of biodiversity, and as a provider of amenity values and marine cultural identity. The report then focuses on the MEDPRO region, providing some estimates of the potential impact of climate change on these services for a given temperature increase scenario. Finally, the effect on ecosystemrelated tourism is computed for the four MEDPRO social economic scenarios. The analysis is enriched by some quantification of the potential costs of adaptation.

The European Union and global security: is the EU becoming the indispensable partner? EU Centre Singapore Background Brief No. 11, April 2014

The European Union has developed new capacity as a security actor in third countries, in particular in the area of crisis management. Over the past two decades the EU has deployed numerous missions, both of a civilian and military nature. Moreover the EU has defined its ability to intervene all along the ‘crisis cycle’, (from prevention to mediation, from peace-keeping to post-conflict reconstruction) and using all tools at its disposal (taking a ‘comprehensive approach’). However the EU is still not perceived as a major security provider globally and interventions remain limited to some geographic areas, mostly in its neighbourhood and Africa, with just a few examples further afield. The EU also tends to avoid taking direct action and seems to prefer partnership arrangements with other players. How can we explain the growing activism and number of EU’s intervention with the low impact and lack of visibility? Can we expect the EU to become more active in the future, taking on more responsibility and leading roles in addressing conflict situations? This paper will argue that the main reason for the EU’s hesitant role in crisis management is to be found in the weak decision-making provisions for EU’s security interventions, as one of the few policy areas still subject to consensus amongst 28 European Union Member States. Lack of a clearer delegation of competence or stronger coordination structures is closely linked to low legitimacy for the EU to take more robust action as a security actor. In order to overcome this legitimacy problem, and in order to facilitate consensus amongst Member States, the EU thus privileges partnership arrangements with other actors who can provide legitimacy and know-how, such as the UN or the African Union. As there is no political desire in the EU for tighter decision-making in this area, we can expect that the EU will continue to play a supporting rather than leading role in crisis management, becoming the partner of choice as it deepens its experience. However this does not mean that the EU is playing just a secondary role in the wider area of security, in particular when looking at nontraditional security. Looking at the role of the EU in Asia, where the EU has deployed just two missions, this paper will offer a broader assessment of the EU as a partner in the area of security taking into account different types of actions. The paper will argue that in order to strengthen cooperation with Asian partners in the area of crisis management, the EU will need to define better what it is able to offer, present its actions as part of an overall strategy rather than ad-hoc and piecemeal, and enter into partnership arrangements with different players in the region.

The Common Security and Defence Policy: National Perspectives. Egmont Paper No. 79, May 2015

FOREWORD. When one looks at the present state of the CSDP, one cannot help but look on with disenchantment at the energy that appears to have abandoned both institutions and Member States. Commentators increasingly take for granted that nothing much should be expected from this field of EU policy. The reasons for this state of mind are well known: the recent economic and financial strains, which have impacted all EU action since 2008, means that most of the Member States will struggle to keep their defence budgets at their present level in the future, and we may even see reductions. Furthermore, and to put it mildly, most of the recent CSDP operations have also experienced a lack of enthusiasm. Adding to this overall trend, the EU is far from presenting a common vision of what security and defence should really mean. Many of the Member States do not want to be involved in all of today’s international turmoils, and they rarely share the strategic culture which inspires those Member States who see themselves as having special responsibilities in dealing with these crises. In the end it may be that Member States diverge fundamentally on the simple question of whether it is relevant for the EU to engage in most of the ‘hot’ crises Europe faces; many prefer to see Europe as a soft power, mostly dedicated to intervening on less dramatic fronts and more inclined to mend than to fight. For whatever reason given, it remains that if there is a lack of common understanding on what CSDP should really be about, it should not come as a surprise if this policy is presently in stalemate. As an additional blow, the Ukrainian crisis, which dragged on for the whole of last year, could only add to the downward spiral the EU has been experiencing, with a new Russia aggressively confronting Europe in a manner not too distant from the Cold War days. This attitude has triggered the natural reaction among EU Member States to seek reassurances from NATO about their own national security. Coupled with the return of France a few years ago into the integrated military command, NATO’s renewed relevance has sent a strong message to Europe about the military organisation’s credibility with regard to collective defence. Surprisingly, this overall trend was gathering momentum at the same time as other more positive developments. The European Council of December 2013 dedicated its main session to CSDP: it underlined Europe’s role as a ‘security provider’ while adopting a very ambitious road map for Europe in all possible dimensions of the security sector. Hence the impression of a genuine boost to all EU institutions, which have been invited to join efforts and give CSDP a reinvigorated efficiency. In the same way, the increasing instability in Europe’s neighbourhood has also called for more EU operations: most recently in Iraq, Libya, Northern Nigeria or South Sudan. Pressure for further EU engagement has been one of the most constant features of the discussions taking place around these crises. Moreover, a growing number of EU partners in Asia, Latin America or Eastern Europe have shown a renewed eagerness to join CSDP missions in what sounds like a vote of confidence for EU capacities. What kind of conclusion should be drawn from this contradictory situation? Probably that the EU has much more potential than it can sometimes figure out itself, if only it would be ready to adapt to the new global realities. But, more than anything else, an enhanced CSDP needs from all Member States strong political will and a clear vision of what they want this policy to be. Without this indispensable ingredient CSDP may continue to run its course, as it does today. It may even grow in efficiency but it will keep lacking the one resource that would definitely help it overcome all the present shortcomings that have prevented Europe from finding its true role and mission through the CSDP. Member States remain central to EU security and defence policy. This is why this collection of essays is so valuable for assessing in no uncertain way the long road that lies ahead for any progress to be made. Pierre VIMONT Senior Associate at Carnegie Europe Former Executive Secretary-General of the European External Action Service

Suplementos alimentares para gestão de peso corporal:

Os suplementos alimentares para emagrecer são um apelo irresistível para quem procura uma forma de perder peso “sem sacrifícios” e “sem esforço”. Com efeito, estamos perante um mercado sazonal em expansão em que a menção “natural” parece tranquilizar os consumidores esquecendo que a eficácia e segurança destes produtos necessita ser avaliada. Nesse contexto, o presente estudo teve como objetivo efetuar a caraterização dos consumidores de suplementos alimentares para emagrecer, da zona centro de Portugal, avaliar o seu grau de satisfação com os produtos e ainda o possível risco que envolve o consumo destes produtos sobretudo quando ingeridos concomitantemente com medicamentos. Recorreu-se a um questionário anónimo, confidencial e de preenchimento voluntário, distribuído em farmácias, parafarmácias e dietéticas e/ou ervanárias maioritariamente do concelho de Viseu e Figueira da Foz. A recolha dos dados decorreu entre os meses de abril e julho de 2014. E tinha como critérios de inclusão ser maior de 18 anos, ambos os sexos e saber ler e escrever. Acorreram 304 indivíduos. A análise dos dados foi feita recorrendo a testes estatísticos adequados a cada caso. O presente estudo ao caracterizar o perfil de consumidores de suplementos alimentares encontrou uma população, maioritariamente feminina (88,5%) com grau de instrução elevado, secundário e superior, nas faixas etária dos 25-44 anos (59,4%), casados ou em união de facto. Apresentavam excesso de peso e obesidade (54%), sem hábitos de prática de exercício físico e com alimentação desequilibrada. Estes preferem adquirir os suplementos alimentares para emagrecer nas farmácias embora a decisão de consumir estes produtos seja pessoal (32,7%). Para aconselhamento preferem o farmacêutico (17,6%) e apenas 4,2% recorrem ao médico. Revelaram ainda consumir estes produtos por um período de tempo limitado, entre 1-3 meses e estarem satisfeitos com os resultados obtidos após o consumo de suplementos alimentares (63,1%). Constituindo os efeitos secundários dos suplementos alimentares uma preocupação legítima verificamos que a maioria dos inquiridos (93,3%) não refere qualquer efeito indesejável, os restantes indivíduos que revelaram aparecimento de ações indesejáveis disseram ter-se dirigido ao farmacêutico para reportar a situação. As patologias com maior prevalência entre os consumidores foram doenças endócrinas, nutricionais e metabólicas, seguida das perturbações mentais e comportamentais e por fim as doenças cardiovasculares a que correspondem os principais grupos terapêuticos encontrados: psicofármacos, medicamentos usados em patologias do sistema endócrino e antihipertensores. Cerca de 25,8% dos inquiridos que consumiam suplementos alimentares para emagrecer utilizavam concomitantemente estes fármacos. A análise dos cinco suplementos alimentares para emagrecer maioritariamente consumidos pela amostra (57,8%) evidenciou a existência de possíveis interações com os grupos de fármacos mais utilizados. Os resultados obtidos mostram por um lado, a necessidade de esclarecer o conceito de que nem tudo o que é natural é inócuo e por outro lado, ressaltam a importância no ato de venda do aconselhamento individual, adaptado a cada consumidor (com ou sem medicação), por um profissional de saúde com conhecimentos no âmbito da gestão e fisiologia de peso corporal e conhecimento sólido sobre a eficácia e segurança destes suplementos.

Financially distressed hospitals : a profile of behavior before and after PPS /

Mode of access: Internet.

A guide for providers of mental health and addictive disorder services in managed care contracting /

Shipping list no.: 99-0117-P.

Inventory of health care facility surveyors : United States - 1976 /

"Contract no. HSA 240-76-0007."

"Streamlined auditing and monitoring of community based services: first steps toward a more efficient system for providers, state government, and the community" : report to the Illinois General Assembly as required by PA 96-1141 /

The Steering Committee recognizes that the Departments may need to implement reviews necessary to address specific Federal requirements and that while consolidated reporting should be used when possible, the review and reporting processes should facilitate the ability to garner Federal funding. However, the analysis thus far confirms the need for change and a significant potential to reduce redundant monitoring and reporting. At the end of this Executive Summary, there is a summary presentation, including a timeline and progress indicators, that gives more details on these recommendations.

Barriers and Facilitators to Treatment among Newly Diagnosed Hypertensive Patients in Nepal: a Qualitative Study

Thesis (Master's)--University of Washington, 2016-06

Parent Engagement in Supported Supervised Visitation in Child Welfare

Thesis (Master's)--University of Washington, 2016-06

Perceptions of Malingering or Factitious Disorder by Army Behavioral health Providers

Thesis (Master's)--University of Washington, 2016-06

Universal Screening for Familial Colorectal Cancer Syndromes at Seattle Cancer Care Alliance: Qualitative Study of Providers involved in Implementation and Patients Experience with First Wave of Testing

Thesis (Master's)--University of Washington, 2016-06

The process of sharing social support in cyberspace

Mutual support is an interactional communication process. Taking an interactional approach to support requires group participants be viewed not only as targets and recipients but also as sources and providers of various types of support. An analysis was performed on the interactions of a group listserv and model of online interactional support. The aim was to explore the communication process children follow. The analysis revealed self-disclosure was used in the support group in three distinct ways. Its function for the support recipient is to initiate a transactional relationship with another member for the purpose of attracting social support through the open expression of concerns and frustrations. It is then used by the support provider to demonstrate that coping is possible for the recipient through the reciprocal self-disclosure of similar concerns and situations with which the member has successfully dealt. The third use of self-disclosure was to share reciprocal social companionship relationships.

Epidemiological analysis of electroconvulsive therapy in Victoria, Australia

Objective: To determine the population-based utilization rate of electroconvulsive therapy (ECT) in Victoria between 1998-1999, to examine the characteristics of the ECT treated group, and to identify patient factors independently associated with differential rates of ECT treatment. Method: Electroconvulsive therapy is reported under statute in Victoria, Australia. Crude, age-adjusted and age-sex specific utilization rates were calculated using this statutory data for the 1998-1999 financial year and estimated mid-year populations from the Australian Bureau of Statistics. Descriptive characteristics of those treated with ECT were derived from the statutory data. Patient factors associated with an increased likelihood of ECT in the public sector were explored with logistic regression analysis, using non-ECT treated mental health patients from the Victorian Psychiatric Case Register as the reference population. Results: The crude treated-person and age-adjusted rates for the State (both public and private sectors) were 39.9 and 44.0 persons per 100 000 resident population per annum, respectively. The crude and age-adjusted administration rates were 330.3 and 362.6 ECT administrations per 100 000 resident population per annum, respectively. Age-sex specific rates varied by age and sex, with rates generally increasing with age and female sex. Overall, 62.8% of the treated group were women, 32.9% aged over 64, and 75.2% had depression. Diagnosis, age and sex each independently predicted ECT in the public sector, with diagnosis the most important factor, followed by age then sex. Conclusions: Despite decades of use, the appropriate rate of ECT utilization is still unclear. Further research should be directed at exploring the factors, including provider variables, determining ECT treatment.