As múltiplas dimensões da garantia dos direitos do paciente idoso internado: o caso de uma instituição hospitalar pública no município de Natal/RN

In the context of current capitalist society, marked by the logic that restricts the human person their status as workforce, in order to generate profits, old age is often treated as an underprivileged life stage. This reality becomes more intense considering the sharp aging process that affects brazilian society is accompanied by the country's entry into a globalized world and tensioned by the dictates of capital. Thus, despite the increasing development of policies to strengthen the guarantee of elderly rights, it is necessary to establish effective strategies of these measures to ensure a higher quality of life to these subjects. Therefore, it is necessary to develop studies that problematize the issue of the elderly, which represent a growing portion of the population, and hence have more visible demands, including in health. With the increase in the elderly population in Brazil it is possible to realize the country is going through a demographic transition and epidemiological changes that contribute to change the landscape of health care of the elderly, especially the hospitalization. Thus, this study aimed to analyze the multiple aspects of ensuring the rights of elderly patients admitted to the State Hospital Dr. Ruy Pereira dos Santos (HRPS), located in Natal / RN, whose most patients are elderly. Specifically sought to understand the aging process, its social consequences and the vulnerability to which it is exposed, especially during the disease situation; understand the process of construction of the Brazilian public health and their actions for older people; learn the expressions of citizenship formation in Brazil with regard to policies for older people; and investigate the design of health professionals about the guarantee of the right of hospitalized elderly. Starting from an integrated coordinated theoretical and practical possibilities, a qualitative research and literature character, documentary and field was held. For this, there were four semi-structured interviews with health research locus Hospital professionals - namely, two social workers, a doctor and a nurse - as well as life stories with the hospitalized elderly patients, one in each deck the said Hospital, totaling three. The results pointed to the difficulty of health policy become effective as law and stressed one historical scenario violation of the rights of elderly hospitalized patients, which persists due to the precarious situation and the difficulty of effective implementation of the Unified Health System (SUS ) and other public policies to that end.

Termos de troca, preço das commodities e o crescimento brasileiro : uma análise sob o prisma da restrição externa

This study aims to investigate the relationship between terms of trade and the long-term growth of Brazilian economy, from the perspective of external constraint, between the period 1994 to 2014. For this purpose, it is based on Thirlwall's (1979) original contribution, in order to empirically test the terms of trade contribution for determining the Brazilian growth potential product equivalent with Balance of Payments equilibriun. Using cointegration method, which seeks to analyze the long-term relationship between the variables, and subdividing the period into two sub-periods, 1994-2004 and 2004-2014, we estimate and compare real and hypothetical income elasticities and predicted and observed growth rates, with and without the terms of trade, for each period. The obteined results show that the inclusion of terms of trade in the empirical procedure to test the validity of Thirlwall's Law lead to higher growth rates obtained by the model (hypothetical), for the entire period 1994-2014 and for the sub-period 2004 -2014. This "theoretical" relaxation of the external constraint, caused by the inclusion of the terms of trade in traditional Thirlwall's rule, overestimated the average real growth rate for these periods, while the traditional Thirlwall's Law - without terms of trade - has adapted better to the real behavior of Brazilian economy. Thus, despite having contributed potentially for the relaxation of external constraint on Brazilian growth, the effect of terms of trade may have been offset by the negative performance of other Balance of Payments components, as capital flows and interest, profits and dividends payments abroad.

Exploring business models to provide a foundation for enhanced eye care services in high street optometric practice

High street optometric practices are for-profit businesses. They mostly provide sight testing and eye examination services and sell optical products, such as spectacles and contact lenses. The sight testing services are often sold at a vastly reduced price and profits are generated primarily through high margin spectacle sales, in a loss leading strategy. Published literature highlights weaknesses in this strategy as it forms a barrier to widening the scope of services provided within optometric practices. This includes specialist non-refraction based services, such as shared care. In addition this business strategy discourages investment in advanced diagnostic equipment and higher professional qualifications. The aim of this thesis was to develop a greater understanding of the traditional loss-leading strategy. The thesis also aimed to assess the plausibility of alternative business models to support the development of specialist non-refraction services within high street optometric practice. This research was based on a single independent optometric practice that specialises in advanced retinal imaging and offers a broad range of shared care services. Specialist non-refraction based services were found to be poor generators of spectacle sales likely due to patient needs and presenting concerns. Alternative business strategies to support these services included charging more realistic professional fees via cost-based pricing and monthly payment plans. These strategies enabled specialist services to be more self-sustainable with less reliance on cross-subsidy from spectacle sales. Furthermore, improving operational efficiency can increase stand-alone profits for specialist services.Practice managers may be reluctant to increase professional fees due to market pressures and confidence. However, this thesis found that patients were accepting of increased professional fees. Practice managers can implement alternative business models to enhance eye care provision in high street optometric practices. These alternative business models also improve revenues and profits generated via clinical services and improve patient loyalty.

Operational expenditure costs for wave energy projects and impacts on financial returns

This paper examines 'availability' and the input metrics of operational expenditure (OPEX) for wave energy projects and reports on a case study which assesses the impact of these inputs on project profit returns. Case study simulations modelled a 75 MW wave energy project at two locations; the west coast of Ireland and the north coast of Portugal. Access and availability with respect to weather windows at both locations are discussed and their impact on energy output and wave farm operations is quantified. The input metrics used to calculate OPEX of wave energy projects are defined as well as the impact of OPEX on project net present value (NPV) and internal rate of return (IRR). Results indicate that access and resultant availability factors have a significant impact on case study results by reducing energy output and correspondingly financial returns. Furthermore, the technology maturity level designated for a project also impacts on availability factors and consequently energy output and NPV. Case study profits proved to be very sensitive to annual OPEX, especially if overhaul and replacement costs were accounted for. As a result of the impact of 'availability' on project profit returns. Feed-in tariffs will need to be tailored to the location in question as well as the device technology maturity level, with case study simulations indicating that high FIT will be required to support early stage WEC projects. (C) 2012 Elsevier Ltd. All rights reserved.

Essays in Industrial Organization

<p>This dissertation extends the empirical industrial organization literature with two essays on strategic decisions of firms in imperfectly competitive markets and one essay on how inertia in consumer choice can result in significant welfare losses. Using data from the airline industry I study a well-known puzzle in the literature whereby incumbent firms decrease fares when Southwest Airlines emerges as a potential entrant, but is not (yet) competing directly. In the first essay I describe this so-called Southwest Effect and use reduced-form analysis to offer possible explanations for why firms may choose to forgo profits today rather than wait until Southwest operates the route. The analysis suggests that incumbent firms are attempting to signal to Southwest that entry is unprofitable so as to deter its entry. The second essay develops this theme by extending a classic model from the IO literature, limit pricing, to a dynamic setting. Calibrations indicate the price cuts observed in the data can be captured by a dynamic limit pricing model. The third essay looks at another concentrated industry, mobile telecoms, and studies how inertia in choice (be it inattention or switching costs) can lead to consumers being on poorly matched cellphone plans and how a simple policy proposal can have a considerable effect on welfare.</p>

Small-scale Fisheries and the Global Economy: Understanding Common-pool Resource Governance in the Context of Market Pressures, Neoliberal Policies, and Transnational Institutions

<p>The purpose of this dissertation is to contribute to a better understanding of how global seafood trade interacts with the governance of small-scale fisheries (SSFs). As global seafood trade expands, SSFs have the potential to experience significant economic, social, and political benefits from participation in export markets. At the same time, market connections that place increasing pressures on resources pose risks to both the ecological and social integrity of SSFs. This dissertation seeks to explore the factors that mediate between the potential benefits and risks of global seafood markets for SSFs, with the goal of developing hypotheses regarding these relationships. </p><p>The empirical investigation consists of a series of case studies from the Yucatan Peninsula, Mexico. This is a particularly rich context in which to study global market connections with SSFs because the SSFs in this region engage in a variety of market-oriented harvests, most notably for octopus, groupers and snappers, lobster, and sea cucumber. Variation in market forms and the institutional diversity of local-level governance arrangements allows the dissertation to explore a number of examples. </p><p>The analysis is guided primarily by common-pool resource (CPR) theory because of the insights it provides regarding the conditions that facilitate collective action and the factors that promote long-lasting resource governance arrangements. Theory from institutional economics and political ecology contribute to the elaboration of a multi-faceted conceptualization of markets for CPR theory, with the aim of facilitating the identification of mechanisms through which markets and CPR governance actually interact. This dissertation conceptualizes markets as sets of institutions that structure the exchange of property rights over fisheries resources, affect the material incentives to harvest resources, and transmit ideas and values about fisheries resources and governance.</p><p> The case studies explore four different mechanisms through which markets potentially influence resource governance: 1) Markets can contribute to costly resource governance activities by offsetting costs through profits, 2) markets can undermine resource governance by generating incentives for noncompliance and lead to overharvesting resources, 3) markets can increase the costs of resource governance, for example by augmenting monitoring and enforcement burdens, and 4) markets can alter values and norms underpinning resource governance by transmitting ideas between local resource users and a variety of market actors. </p><p>Data collected using participant observation, survey, informal and structured interviews contributed to the elaboration of the following hypotheses relevant to interactions between global seafood trade and SSFs governance. 1) Roll-back neoliberalization of fisheries policies has undermined cooperatives’ ability to achieve financial success through engagement with markets and thus their potential role as key actors in resource governance (chapter two). 2) Different relations of production influence whether local governance institutions will erode or strengthen when faced with market pressures. In particular, relations of production in which fishers own their own means of production and share the collective costs of governance are more likely to strengthen resource governance while relations of production in which a single entrepreneur controls capital and access to the fishery are more likely to contribute to the erosion of resource governance institutions in the face of market pressures (chapter three). 3) By serving as a new discursive framework within which to conceive of and talk about fisheries resources, markets can influence norms and values that shape and constitute governance arrangements.</p><p>In sum, the dissertation demonstrates that global seafood trade manifests in a diversity of local forms and effects. Whether SSFs moderate risks and take advantage of benefits depends on a variety of factors, and resource users themselves have the potential to influence the outcomes of seafood market connections through local forms of collective action.</p>

Consumer Behavior and Firm Competition

<p>Understanding consumer behavior is critical for firms' decision making. How consumers make decisions about what they want and buy directly affect the profits of firms. Therefore, it is important to consider consumer behaviors and incorporate them into the model when studying the optimal strategy of firms and competition between firms. In this dissertation, I study rich and interesting consumer behaviors and their impact on firms' strategy in two essays. The first essay considers consumers' shopping cost which leads to their preference for one-stop shopping. I examine how store visit costs and consumer knowledge about a product affect the strategic store choice of consumers and, in turn, the pricing, customer service and advertising decisions of competing retailers. My analysis offers insights on how specialty stores can compete with big-box retailers. In the second essay, I focus on a well-established psychology phenomenon, cognitive dissonance. I incorporate the idea of cognitive dissonance into a model of spatial competition and examine its implications for selling strategy. I provide new insight on the profitability of advance selling and spot selling as well as the pricing of bundle and its components. Collectively, two essays in this dissertation introduce novel ways to model consumer behaviors and help to understand the impact of consumer behaviors on firm profitability and strategy.</p>

Essays on Energy Economics and Industrial Organization

<p>The dissertation consists of three chapters related to the low-price guarantee marketing strategy and energy efficiency analysis. The low-price guarantee is a marketing strategy in which firms promise to charge consumers the lowest price among their competitors. Chapter 1 addresses the research question "Does a Low-Price Guarantee Induce Lower Prices'' by looking into the retail gasoline industry in Quebec where there was a major branded firm which started a low-price guarantee back in 1996. Chapter 2 does a consumer welfare analysis of low-price guarantees to drive police indications and offers a new explanation of the firms' incentives to adopt a low-price guarantee. Chapter 3 develops the energy performance indicators (EPIs) to measure energy efficiency of the manufacturing plants in pulp, paper and paperboard industry.</p><p>Chapter 1 revisits the traditional view that a low-price guarantee results in higher prices by facilitating collusion. Using accurate market definitions and station-level data from the retail gasoline industry in Quebec, I conducted a descriptive analysis based on stations and price zones to compare the price and sales movement before and after the guarantee was adopted. I find that, contrary to the traditional view, the stores that offered the guarantee significantly decreased their prices and increased their sales. I also build a difference-in-difference model to quantify the decrease in posted price of the stores that offered the guarantee to be 0.7 cents per liter. While this change is significant, I do not find the response in comeptitors' prices to be significant. The sales of the stores that offered the guarantee increased significantly while the competitors' sales decreased significantly. However, the significance vanishes if I use the station clustered standard errors. Comparing my observations and the predictions of different theories of modeling low-price guarantees, I conclude the empirical evidence here supports that the low-price guarantee is a simple commitment device and induces lower prices. </p><p>Chapter 2 conducts a consumer welfare analysis of low-price guarantees to address the antitrust concerns and potential regulations from the government; explains the firms' potential incentives to adopt a low-price guarantee. Using station-level data from the retail gasoline industry in Quebec, I estimated consumers' demand of gasoline by a structural model with spatial competition incorporating the low-price guarantee as a commitment device, which allows firms to pre-commit to charge the lowest price among their competitors. The counterfactual analysis under the Bertrand competition setting shows that the stores that offered the guarantee attracted a lot more consumers and decreased their posted price by 0.6 cents per liter. Although the matching stores suffered a decrease in profits from gasoline sales, they are incentivized to adopt the low-price guarantee to attract more consumers to visit the store likely increasing profits at attached convenience stores. Firms have strong incentives to adopt a low-price guarantee on the product that their consumers are most price-sensitive about, while earning a profit from the products that are not covered in the guarantee. I estimate that consumers earn about 0.3% more surplus when the low-price guarantee is in place, which suggests that the authorities should not be concerned and regulate low-price guarantees. In Appendix B, I also propose an empirical model to look into how low-price guarantees would change consumer search behavior and whether consumer search plays an important role in estimating consumer surplus accurately.</p><p>Chapter 3, joint with Gale Boyd, describes work with the pulp, paper, and paperboard (PP&PB) industry to provide a plant-level indicator of energy efficiency for facilities that produce various types of paper products in the United States. Organizations that implement strategic energy management programs undertake a set of activities that, if carried out properly, have the potential to deliver sustained energy savings. Energy performance benchmarking is a key activity of strategic energy management and one way to enable companies to set energy efficiency targets for manufacturing facilities. The opportunity to assess plant energy performance through a comparison with similar plants in its industry is a highly desirable and strategic method of benchmarking for industrial energy managers. However, access to energy performance data for conducting industry benchmarking is usually unavailable to most industrial energy managers. The U.S. Environmental Protection Agency (EPA), through its ENERGY STAR program, seeks to overcome this barrier through the development of manufacturing sector-based plant energy performance indicators (EPIs) that encourage U.S. industries to use energy more efficiently. In the development of the energy performance indicator tools, consideration is given to the role that performance-based indicators play in motivating change; the steps necessary for indicator development, from interacting with an industry in securing adequate data for the indicator; and actual application and use of an indicator when complete. How indicators are employed in EPA’s efforts to encourage industries to voluntarily improve their use of energy is discussed as well. The chapter describes the data and statistical methods used to construct the EPI for plants within selected segments of the pulp, paper, and paperboard industry: specifically pulp mills and integrated paper & paperboard mills. The individual equations are presented, as are the instructions for using those equations as implemented in an associated Microsoft Excel-based spreadsheet tool.</p>

Capacity Investment in Renewable and Conventional Energy Sources

<p>This dissertation studies capacity investments in energy sources, with a focus on renewable technologies, such as solar and wind energy. We develop analytical models to provide insights for policymakers and use real data from the state of Texas to corroborate our findings. </p><p>We first take a strategic perspective and focus on electricity pricing policies. Specifically, we investigate the capacity investments of a utility firm in renewable and conventional energy sources under flat and peak pricing policies. We consider generation patterns and intermittency of solar and wind energy in relation to the electricity demand throughout a day. We find that flat pricing leads to a higher investment level for solar energy and it can still lead to more investments in wind energy if considerable amount of wind energy is generated throughout the day.</p><p>In the second essay, we complement the first one by focusing on the problem of matching supply with demand in every operating period (e.g., every five minutes) from the perspective of a utility firm. We study the interaction between renewable and conventional sources with different levels of operational flexibility, i.e., the possibility</p><p>of quickly ramping energy output up or down. We show that operational flexibility determines these interactions: renewable and inflexible sources (e.g., nuclear energy) are substitutes, whereas renewable and flexible sources (e.g., natural gas) are complements. </p><p>In the final essay, rather than the capacity investments of the utility firms, we focus on the capacity investments of households in rooftop solar panels. We investigate whether or not these investments may cause a utility death spiral effect, which is a vicious circle of increased solar adoption and higher electricity prices. We observe that the current rate-of-return regulation may lead to a death spiral for utility firms. We show that one way to reverse the spiral effect is to allow the utility firms to maximize their profits by determining electricity prices.</p>

Delay-Sensitive Service Request Scheduling for Cloud Computing

Cloud computing realizes the long-held dream of converting computing capability into a type of utility. It has the potential to fundamentally change the landscape of the IT industry and our way of life. However, as cloud computing expanding substantially in both scale and scope, ensuring its sustainable growth is a critical problem. Service providers have long been suffering from high operational costs. Especially the costs associated with the skyrocketing power consumption of large data centers. In the meantime, while efficient power/energy utilization is indispensable for the sustainable growth of cloud computing, service providers must also satisfy a user's quality of service (QoS) requirements. This problem becomes even more challenging considering the increasingly stringent power/energy and QoS constraints, as well as other factors such as the highly dynamic, heterogeneous, and distributed nature of the computing infrastructures, etc. In this dissertation, we study the problem of delay-sensitive cloud service scheduling for the sustainable development of cloud computing. We first focus our research on the development of scheduling methods for delay-sensitive cloud services on a single server with the goal of maximizing a service provider's profit. We then extend our study to scheduling cloud services in distributed environments. In particular, we develop a queue-based model and derive efficient request dispatching and processing decisions in a multi-electricity-market environment to improve the profits for service providers. We next study a problem of multi-tier service scheduling. By carefully assigning sub deadlines to the service tiers, our approach can significantly improve resource usage efficiencies with statistically guaranteed QoS. Finally, we study the power conscious resource provision problem for service requests with different QoS requirements. By properly sharing computing resources among different requests, our method statistically guarantees all QoS requirements with a minimized number of powered-on servers and thus the power consumptions. The significance of our research is that it is one part of the integrated effort from both industry and academia to ensure the sustainable growth of cloud computing as it continues to evolve and change our society profoundly.

Low cost carriers and the changing fortunes of airports in the UK

This paper investigates how low cost carrier (LCC) developments have affected the traffic and financial performance of UK airports from 2002 to 2014. Considerable growth in traffic was experienced from 2002 to 2007, especially at regional airports as a result of LCC expansion. This was replaced with a more volatile period from 2008 to 2014 where many of the regional airports that experienced the greatest increases in traffic during the early years, then experienced the largest reductions. This has clearly had an impact on their financial well-being, resulting in reduced profits for many airports. It has also meant that many regional airports that seemed like attractive investments as a result of LCC expansion are now less financially appealing, especially given that the LCC sector in the UK appears to be shifting capacity to larger regional airports, and in some cases, London airports.

The War at Home

The reform of cities spaces and housing has been a key issue with campaigners on the left for more than a century. These campaigns have found allies in the work of socially committed photographers from Jacob Riis at the turn of the twentieth century to Margaret Morton and Camilo Jose Vergara today. Globally the current phase of neo-liberalism has brought its own issues to the city as ‘regeneration’ strategies dispossess the urban poor in areas that are potentially lucrative to real estate development. In this process known as ‘accumulation by dispossession’ large profits are accumulated in the process of dispossessing people of their land, rights and homes. Central to the theoretical component of this paper, is an interrogation of contemporary ideas on the production and photographic representation of urban space. The research hence questions photography’s ability to make ‘legible’ the key drivers of today’s emergent terrains and to visualize their connections to the networks of power and capital that articulate the current political economy (Sassen 2011:36). One strand here will be the ‘fleshing out’ of the cultural practices behind photographers mediating urban development (Jones 2013: 1.2). Alongside current corporate depictions historical precedents will be discussed. Photographers as far back as Charles Marville in Paris of the 1850’s have documented urban reconstruction (Kennel 2013). Often employed by those undertaking the demolition, these photographic images frequently suppress certain narratives of the unbuilding process. Acting as a propaganda tool they eliminate the impact on the lives of inhabitants or the economic realities driving the valorization of reconstruction schemes (James 2004). Reformist documentary images have also played their part in justifying large-scale urban reconstruction that involved the eventual displacement of existing communities (Rose 1997: Blaikie 2006). Focusing on the gentrification of social housing in Pendleton, Salford (Greater Manchester) the presentation will explore the artists’ own work through a critical discussion, photographic images and excerpts from site writing they’ve undertaken in the area since 2004. It asks can an alternative photographic and visual strategy provide a meaningful political counter narrative to combat persuasive corporate discourses on ‘urban revitalization’? The paper will explore strategies and techniques of witnessing and ask whether these types of record can counter neo-liberal visualizations that mediate the material transformation of city areas. Can such representations begin a critical conversation about the nature of urban change and who benefits from these transformations (Wyly 2010)? Can we develop this critical photography into a type of practice that moves beyond generalisations and talks about social relations though an ‘explicit analysis of society’ (Rosler 2004:195).

Clipped wings: corporate social and environmental responsibility in the airline industry

Within the developed world, airlines have responded to the advice of advocates for corporate social and environmental responsibility (CSER) to use the intertwined CSER dimensions of economics, society and environment to guide their business activities. However, disingenuously, the advocates and regulators frequently pay insufficient attention to the economics which are critical to airlines’ sustainability and profits. This omission pushes airlines into the unprofitable domain of CSERplus. The author identifies alleged market inefficiencies and failures, examines CSERplus impacts on international competition and assesses the unintended consequences of the regulations. She also provides innovative ideas for future-proofing airlines.　 Clipped Wings is a treatise for business professionals featuring academic research as well as industry anecdotes. It is written for airlines (including their owners, employees, passengers and suppliers), airports, trade associations, policy makers, educators, students, consultants, CSERplus specialists and anyone who is concerned about the future of competitive airlines.

As assessment of the Competition Commission Report and subsequent outcomes

Following the Office of Fair Trading's review of the British deregulated bus market as a whole in 2009, the issues raised were referred to the Competition Commission. Its final report was published in December 2011. Subsequently, the House of Commons Transport Committee carried out an enquiry into the Commission's report, and reactions to it by the operating industry, user groups, and other bodies, which was published in September 2012. A number of major issues have been raised, including the extent to which price competition may be effective, the appropriate rate of return on capital that would be expected within the industry (and appropriate actions where this is excessive in practice), and industry structure. The importance of competition per se, as distinct from attributes of direct concern to users (such as reliability, frequency, and fares) has also been debated. This paper reviews the issues raised, and outcomes to date, in the light of further evidence on the industry's performance. It is demonstrated similar rates of return could be attained through very different operating strategies, which in turn have very different implications for changes in consumer surplus. The alternative uses made of such profits (for example through reinvestment) may also have markedly different impacts effects on users. Rather than focussing on the dangers of excessive rates of return on capital, the outcomes for service users should be the main issue.

Commodification of health care systems: The Catalan case

Commodification of the public healthcare system has been a growing process in recent decades, especially in universal healthcare systems and in high-income countries like Spain.  There are substantial differences in the healthcare systems of each autonomous region of Spain, among which Catalonia is characterized by having a mixed healthcare system with complex partnerships and interactions between the public and private healthcare sectors.  Using a narrative review approach, this article addresses various aspects of the Catalan healthcare system, characterizing the privatization and commodification of health processes in Catalonia from a historical perspective with particular attention to recent legislative changes and austerity measures.  The article approximates, the eventual effects that commodification and austerity measures will have on the health of the population and on the structure, accessibility, effectiveness, equity and quality of healthcare services.