Beyond pure public and pure private management models: Partial privatization in the European airport industry

The use of private funding and management is enjoying an increasing trend in airports. The literature has not paid enough attention to the mixed management models in this industry, although many European airports take the form of mixed public-private companies, where ownership is shared between public and private sectors. We examine the determinants of the degree of private participation in the European airport sector. Drawing on a sample of the 100 largest European airports, we estimate a multivariate equation in order to determine the role of airport characteristics, fiscal variables, and political factors on the extent of private involvement. Our results confirm the alignment between public and private interests in partially privatized airports. Fiscal constraints and market attractiveness promote private participation. Integrated governance models and the share of network carriers prevent the presence of private ownership, while the degree of private participation appears to be pragmatic rather than ideological.

Beyond pure public and pure private management models: Mixed firms in the European Airport Industry

The use of private funding and management enjoys an increasing trend in airports. The literature has not paid enough attention to the mixed management models in this industry, although many European airports take the form of mixed firms or Institutional PPP, where ownership is shared between public and private sectors. We examine the determinants of the degree of private participation in the European airport sector. Drawing on a sample of the 100 largest European airports we estimate a multivariate equation in order to determine the role of airport characteristics, fiscal variables and political factors on the extent of private involvement. Our results confirm the alignment between public and private interests in PPPs. Fiscal constraints and market attractiveness promote private participation. Integrated governance models and the share of network carriers prevent the presence of private ownership, while the degree of private participation appears to be pragmatic rather than ideological.

Ownership, Incentives and Hospitals

This article analyzes hospital privatization by comparing costs and quality between different ownership forms. We put the attention on the distinction between public hospitals and private hospitals with public funding. Using information about Spanish hospitals, we have found that private hospitals provide services at a lower cost at expenses of lower quality. We observe that property rights theory is fulfilled at least for the Spanish hospital market. The way that Heath Authorities finance publicly funded hospitals may be responsible for the differences in incentives between public and private centers. We argue that the trade-off between costs and quality could be minimized by designing financing contracts with fixed and variable components.

Neoadjuvant chemotherapy and extrapleural pneumonectomy of malignant pleural mesothelioma with or without hemithoracic radiotherapy (SAKK 17/04): a randomised, international, multicentre phase 2 trial.

BACKGROUND: Postoperative hemithoracic radiotherapy has been used to treat malignant pleural mesothelioma, but it has not been assessed in a randomised trial. We assessed high-dose hemithoracic radiotherapy after neoadjuvant chemotherapy and extrapleural pneumonectomy in patients with malignant pleural mesothelioma. METHODS: We did this phase 2 trial in two parts at 14 hospitals in Switzerland, Belgium, and Germany. We enrolled patients with pathologically confirmed malignant pleural mesothelioma; resectable TNM stages T1-3 N0-2, M0; WHO performance status 0-1; age 18-70 years. In part 1, patients were given three cycles of neoadjuvant chemotherapy (cisplatin 75 mg/m(2) and pemetrexed 500 mg/m(2) on day 1 given every 3 weeks) and extrapleural pneumonectomy; the primary endpoint was complete macroscopic resection (R0-1). In part 2, participants with complete macroscopic resection were randomly assigned (1:1) to receive high-dose radiotherapy or not. The target volume for radiotherapy encompassed the entire hemithorax, the thoracotomy channel, and mediastinal nodal stations if affected by the disease or violated surgically. A boost was given to areas at high risk for locoregional relapse. The allocation was stratified by centre, histology (sarcomatoid vs epithelioid or mixed), mediastinal lymph node involvement (N0-1 vs N2), and T stage (T1-2 vs T3). The primary endpoint of part 1 was the proportion of patients achieving complete macroscopic resection (R0 and R1). The primary endpoint in part 2 was locoregional relapse-free survival, analysed by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT00334594. FINDINGS: We enrolled patients between Dec 7, 2005, and Oct 17, 2012. Overall, we analysed 151 patients receiving neoadjuvant chemotherapy, of whom 113 (75%) had extrapleural pneumonectomy. Median follow-up was 54·2 months (IQR 32-66). 52 (34%) of 151 patients achieved an objective response. The most common grade 3 or 4 toxic effects were neutropenia (21 [14%] of 151 patients), anaemia (11 [7%]), and nausea or vomiting (eight [5%]). 113 patients had extrapleural pneumonectomy, with complete macroscopic resection achieved in 96 (64%) of 151 patients. We enrolled 54 patients in part 2; 27 in each group. The main reasons for exclusion were patient refusal (n=20) and ineligibility (n=10). 25 of 27 patients completed radiotherapy. Median total radiotherapy dose was 55·9 Gy (IQR 46·8-56·0). Median locoregional relapse-free survival from surgery, was 7·6 months (95% CI 4·5-10·7) in the no radiotherapy group and 9·4 months (6·5-11·9) in the radiotherapy group. The most common grade 3 or higher toxic effects related to radiotherapy were nausea or vomiting (three [11%] of 27 patients), oesophagitis (two [7%]), and pneumonitis (two [7%]). One patient died of pneumonitis. We recorded no toxic effects data for the control group. INTERPRETATION: Our findings do not support the routine use of hemithoracic radiotherapy for malignant pleural mesothelioma after neoadjuvant chemotherapy and extrapleural pneumonectomy. FUNDING: Swiss Group for Clinical Cancer Research, Swiss State Secretariat for Education, Research and Innovation, Eli Lilly.

Safety and immunogenicity of a chimpanzee adenovirus-vectored Ebola vaccine in healthy adults: a randomised, double-blind, placebo-controlled, dose-finding, phase 1/2a study.

BACKGROUND: The ongoing Ebola outbreak led to accelerated efforts to test vaccine candidates. On the basis of a request by WHO, we aimed to assess the safety and immunogenicity of the monovalent, recombinant, chimpanzee adenovirus type-3 vector-based Ebola Zaire vaccine (ChAd3-EBO-Z). METHODS: We did this randomised, double-blind, placebo-controlled, dose-finding, phase 1/2a trial at the Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Participants (aged 18-65 years) were randomly assigned (2:2:1), via two computer-generated randomisation lists for individuals potentially deployed in endemic areas and those not deployed, to receive a single intramuscular dose of high-dose vaccine (5 × 10(10) viral particles), low-dose vaccine (2·5 × 10(10) viral particles), or placebo. Deployed participants were allocated to only the vaccine groups. Group allocation was concealed from non-deployed participants, investigators, and outcome assessors. The safety evaluation was not masked for potentially deployed participants, who were therefore not included in the safety analysis for comparison between the vaccine doses and placebo, but were pooled with the non-deployed group to compare immunogenicity. The main objectives were safety and immunogenicity of ChAd3-EBO-Z. We did analysis by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02289027. FINDINGS: Between Oct 24, 2014, and June 22, 2015, we randomly assigned 120 participants, of whom 18 (15%) were potentially deployed and 102 (85%) were non-deployed, to receive high-dose vaccine (n=49), low-dose vaccine (n=51), or placebo (n=20). Participants were followed up for 6 months. No vaccine-related serious adverse events were reported. We recorded local adverse events in 30 (75%) of 40 participants in the high-dose group, 33 (79%) of 42 participants in the low-dose group, and five (25%) of 20 participants in the placebo group. Fatigue or malaise was the most common systemic adverse event, reported in 25 (62%) participants in the high-dose group, 25 (60%) participants in the low-dose group, and five (25%) participants in the placebo group, followed by headache, reported in 23 (57%), 25 (60%), and three (15%) participants, respectively. Fever occurred 24 h after injection in 12 (30%) participants in the high-dose group and 11 (26%) participants in the low-dose group versus one (5%) participant in the placebo group. Geometric mean concentrations of IgG antibodies against Ebola glycoprotein peaked on day 28 at 51 μg/mL (95% CI 41·1-63·3) in the high-dose group, 44·9 μg/mL (25·8-56·3) in the low-dose group, and 5·2 μg/mL (3·5-7·6) in the placebo group, with respective response rates of 96% (95% CI 85·7-99·5), 96% (86·5-99·5), and 5% (0·1-24·9). Geometric mean concentrations decreased by day 180 to 25·5 μg/mL (95% CI 20·6-31·5) in the high-dose group, 22·1 μg/mL (19·3-28·6) in the low-dose group, and 3·2 μg/mL (2·4-4·9) in the placebo group. 28 (57%) participants given high-dose vaccine and 31 (61%) participants given low-dose vaccine developed glycoprotein-specific CD4 cell responses, and 33 (67%) and 35 (69%), respectively, developed CD8 responses. INTERPRETATION: ChAd3-EBO-Z was safe and well tolerated, although mild to moderate systemic adverse events were common. A single dose was immunogenic in almost all vaccine recipients. Antibody responses were still significantly present at 6 months. There was no significant difference between doses for safety and immunogenicity outcomes. This acceptable safety profile provides a reliable basis to proceed with phase 2 and phase 3 efficacy trials in Africa. FUNDING: Swiss State Secretariat for Education, Research and Innovation (SERI), through the EU Horizon 2020 Research and Innovation Programme.

Freshwater biodiversity and conservation in mediterranean climate streams of Chile.

In Chile, mediterranean climate conditions only occur in the Central Zone (ChMZ). Despite its small area, this mediterranean climate region (med-region) has been recognised as a hotspot for biodiversity. However, in contrast to the rivers of other med-regions, the rivers in the ChMZ have been studied infrequently, and knowledge of their freshwater biodiversity is scarce and fragmented. We gathered information on the freshwater biodiversity of ChMZ, and present a review of the current knowledge of the principal floral and faunal groups. Existing knowledge indicates that the ChMZ has high levels of endemism, with many primitive species being of Gondwanan origin. Although detailed information is available on most floral groups, most faunal groups remain poorly known. In addition, numerous rivers in the ChMZ remain completely unexplored. Taxonomic specialists are scarce, and the information available on freshwater biodiversity has resulted from studies with objectives that did not directly address biodiversity issues. Research funding in this med-region has a strong applied character and is not focused on the knowledge of natural systems and their biodiversity. Species conservation policies are urgently required in this highly diverse med-region, which is also the most severely impacted and most populated region of the country.

Offshore Sourcing in Software Development: Case Studies of Finnish-Russian Cooperation

The study examines international cooperation in product development in software development organisations. The software industry is known for its global nature and knowledge-intensity, which makes it an interesting setting to examine international cooperation in. Software development processes are increasingly distributed worldwide, but for small or even medium-sized enterprises, typical for the software industry, such distribution of operations is often possible only in association with crossing the company’s boundaries. The strategic decision-making of companies is likely to be affected by the characteristics of the industry, and this includes decisions about cooperation or sourcing. The objective of this thesis is to provide a holistic view on factors affecting decisions about offshore sourcing in software development. Offshore sourcing refers to a cooperative mode of offshoring, where a firm does not establish its own presence in a foreign country, but utilises a local supplier. The study examines product development activities that are distributed across organisational and geographical boundaries. The objective can be divided into two subtopics: general reasons for international cooperation in product development and particular reasons for cooperation between Finnish and Russian companies. The focus is on the strategic rationale at the company level, in particular in small and medium-sized enterprises. The theoretical discourse of the study builds upon the literature on international cooperation and networking, with particular focus on cooperation with foreign suppliers and within product development activities. The resource-based view is also discussed, as heterogeneity and interdependency of the resources possessed by different firms are seen as factors motivating international cooperation. Strategically, sourcing can be used to access resources possessed by an industrial network, to enhance the product development of a firm, or to optimise its cost structure. In order to investigate the issues raised by the theoretical review, two empirical studies on international cooperation in software product development have been conducted. The emphasis of the empirical part of the study is on cooperation between Finnish and Russian companies. The data has been gathered through four case studies on Finnish software development organisations and four case studies on Russian offshore suppliers. Based on the material from the case studies, a framework clarifying and grouping the factors that influence offshore sourcing decisions has been built. The findings indicate that decisions regarding offshore sourcing in software development are far more complex than generally assumed. The framework provides a holistic view on factors affecting decisions about offshore sourcing in software development, capturing the multidimensionality of motives for entering offshore cooperation. Four groups of factors emerged from the data: A) strategy-related aspects, B) aspects related to resources and capabilities, C) organisation-related aspects, and D) aspects related to the entrepreneur or management. By developing a holistic framework of decision factors, the research offers in-depth theoreticalunderstanding of offshore sourcing rationale in product development. From the managerial point of view, the proposed framework sums up the issues that a firm should pay attention to when contemplating product development cooperation with foreign suppliers. Understanding different components of sourcing decisions can lead to improved preconditions for strategising and engaging in offshore cooperation. A thorough decisionmaking process should consider all the possible benefits and risks of product development cooperation carefully.

Structuration and branding of a religious tourism product: Catalonia sacra

This article aims to provide an overview of the products Catalonia has to offer in terms of religious tourism. The growing interest in this kind of tourism worldwide, and in Catalonia itself, along with the region's wealth of religious heritage (particularly connected to the Christian Church) contrast with the lack of religion-based tourism products available, which results in its absence from the region's image as a tourism destination. In view of this, the Faculty of Tourism (University of Girona), the Vic Bishopric's Albergueria-Centre for Cultural Dissemination and the Tarraconense Episcopal Conference's Interdiocese Secretariat for the Custody and Promotion of Holy Art (SICPAS) decided to address the situation with the help of funding from the Autonomous Government of Catalonia. In order to re-position Christian religious heritage in the image of Catalonia as a tourist destination, the aforementioned parties embarked upon a project to set up a series of routes throughout the region, branded under the name Catalonia Sacra

Privatization and Regulation of Toll Motorways in Europe

The private sector plays an increasing and relevant role in highway funding and management. For that reason, the regulation designed and enforced by public authorities becomes even more important for the social welfare results generated by this process. In this study, we analyze the current trends in highway funding and management paying special attention on the recent process of privatization and its motivations. Since public ownership and regulation are substitutes for government intervention, we check the hypothesis that highways privatization induces more strict regulation. Indeed, we observe that as the private sector increases its size, toll regulation becomes more detailed.

Merchandising Strategies and Retail Performance for Seasonal Fashion Products

This study presents mathematical methods for evaluation of retail performance with special regard to product sourcing strategies. Forecast accuracy, process lead time, offshore / local sourcing mix and up front / replenishment buying mix are defined as critical success factors in connection with sourcing seasonal products with a fashion content. As success measures, this research focuses on service level, lost sales, product substitute percentage, gross margin, gross margin return on inventory and mark down rate. The accuracy of demand forecast is found to be a fundamental success factor. Forecast accuracy depends on lead time. Lead times are traditionally long and buying decisions are made seven to eight months prior to the start of the selling season. Forecast errors cause stockouts and lost sales. Some of the products bought for the selling season will not be sold and have to be marked down and sold at clearance, causing loss of gross margin. Gross margin percentage is not the best tool for evaluating sourcing decisions and in the context of this study gross margin return on inventory, which combines profitability and assets management, is used. The findings of this research suggest that there are more profitable ways of sourcing products than buying them from low cost offshore sources. Mixing up front and inseason replenishment deliveries, especially when point of sale information is used for improving forecast accuracy, results in better retail performance. Quick Response and Vendor Managed Inventory strategies yield better results than traditional up front buying from offshore even if local purchase prices are higher. Increasing the number of selling seasons, slight over buying for the season in order to

Impact of maternity care policy in Catalonia: a retrospective cross-sectional study of service delivery in public and private hospitals

Background: As a result of the growing number of interventions that are now performed in the context of maternity care, health authorities have begun to examine the possible repercussions for service provision and for maternal and neonatal health. In Spain the Strategy Paper on Normal Childbirth was published in 2008, and since then the authorities in Catalonia have sought to implement its recommendations. This paper reviews the current provision of maternity care in Catalonia. Methods: This was a descriptive study. Hospitals were grouped according to their source of funding (public or private) and were stratified (across four strata) on the basis of the annual number of births recorded within their respective maternity service. Data regarding the distribution of obstetric professionals were taken from an official government survey of hospitals published in 2010. The data on obstetric interventions (caesarean, use of forceps, vacuum or non-specified instruments) performed in 2007, 2010 and 2012 were obtained by consulting discharge records of 44 public and 20 private hospitals, which together provide care in 98% of all births in Catalonia. Proportions and confidence intervals were calculated for each intervention performed in all full-term (3742 weeks) singleton births. Results: Analysis of staff profiles according to the stratification of hospitals showed that almost all the hospitals had more obstetricians than midwives among their maternity care staff. Public hospitals performed fewer caesareans [range between 19.20% (CI 18.84-19.55) and 28.14% (CI 27.73-28.54)] than did private hospitals [range between 32.21% (CI 31.78-32.63) and 39.43% (CI 38.98-39.87)]. The use of forceps has decreased in public hospitals. The use of a vacuum extractor has increased and is more common in private hospitals. Conclusions: Caesarean section is the most common obstetric intervention performed during full-term singleton births in Catalonia. The observed trend is stable in the group of public hospitals, but shows signs of a rise among private institutions. The number of caesareans performed in accredited public hospitals covers a limited range with a stable trend. Among public hospitals the highest rate of caesareans is found in non-accredited hospitals with a lower annual number of births.

Impact of maternity care policy in Catalonia: a retrospective cross-sectional study of service delivery in public and private hospitals

Background: As a result of the growing number of interventions that are now performed in the context of maternity care, health authorities have begun to examine the possible repercussions for service provision and for maternal and neonatal health. In Spain the Strategy Paper on Normal Childbirth was published in 2008, and since then the authorities in Catalonia have sought to implement its recommendations. This paper reviews the current provision of maternity care in Catalonia. Methods: This was a descriptive study. Hospitals were grouped according to their source of funding (public or private) and were stratified (across four strata) on the basis of the annual number of births recorded within their respective maternity service. Data regarding the distribution of obstetric professionals were taken from an official government survey of hospitals published in 2010. The data on obstetric interventions (caesarean, use of forceps, vacuum or non-specified instruments) performed in 2007, 2010 and 2012 were obtained by consulting discharge records of 44 public and 20 private hospitals, which together provide care in 98% of all births in Catalonia. Proportions and confidence intervals were calculated for each intervention performed in all full-term (3742 weeks) singleton births. Results: Analysis of staff profiles according to the stratification of hospitals showed that almost all the hospitals had more obstetricians than midwives among their maternity care staff. Public hospitals performed fewer caesareans [range between 19.20% (CI 18.84-19.55) and 28.14% (CI 27.73-28.54)] than did private hospitals [range between 32.21% (CI 31.78-32.63) and 39.43% (CI 38.98-39.87)]. The use of forceps has decreased in public hospitals. The use of a vacuum extractor has increased and is more common in private hospitals. Conclusions: Caesarean section is the most common obstetric intervention performed during full-term singleton births in Catalonia. The observed trend is stable in the group of public hospitals, but shows signs of a rise among private institutions. The number of caesareans performed in accredited public hospitals covers a limited range with a stable trend. Among public hospitals the highest rate of caesareans is found in non-accredited hospitals with a lower annual number of births.

Success factors of customer and supplier master data system

Especially in global enterprises, key data is fragmented in multiple Enterprise Resource Planning (ERP) systems. Thus the data is inconsistent, fragmented and redundant across the various systems. Master Data Management (MDM) is a concept, which creates cross-references between customers, suppliers and business units, and enables corporate hierarchies and structures. The overall goal for MDM is the ability to create an enterprise-wide consistent data model, which enables analyzing and reporting customer and supplier data. The goal of the study was defining the properties and success factors of a master data system. The theoretical background was based on literature and the case consisted of enterprise specific needs and demands. The theoretical part presents the concept, background, and principles of MDM and then the phases of system planning and implementation project. Case consists of background, definition of as is situation, definition of project, evaluation criterions and concludes the key results of the thesis. In the end chapter Conclusions combines common principles with the results of the case. The case part ended up dividing important factors of the system in success factors, technical requirements and business benefits. To clarify the project and find funding for the project, business benefits have to be defined and the realization has to be monitored. The thesis found out six success factors for the MDM system: Well defined business case, data management and monitoring, data models and structures defined and maintained, customer and supplier data governance, delivery and quality, commitment, and continuous communication with business. Technical requirements emerged several times during the thesis and therefore those can’t be ignored in the project. Conclusions chapter goes through these factors on a general level. The success factors and technical requirements are related to the essentials of MDM: Governance, Action and Quality. This chapter could be used as guidance in a master data management project.

Developing the Sourcing with the Purchasing Tool in the Chemical Company

The aim of this research was to investigate Tikkurila Oyj's Vantaa factories' current status in procurement and to develop the reporting of purchases and purchase warehouses, and to measure the activities during the implementation of the new purchasing tool. The implemented purchasing tool was based on ABC-analysis. Based on its reports the importance of performance measurements for the operations of the company, and the purpose of getting transparency to the company's supply chain on the part of purchasing were examined. A successful purchase- and material operation calls for accurate knowledge and professional skills. The research proved that with a separate purchasing tool, that analyses the existing information of the company's production management system, it is possible to get added value to whole supply chain's needs. The analyses and reports of the purchasing tool enable a more harmonized purchasing process at the operative level, and create a basis for internal targets and to their follow-up. At the same time the analyses clarify the current status and development trends of procurement fresh to the management. The increase of the possibilities of exploitation of information technology enables a perfect transparency to the case company's purchase department.

Adherence and perceptions regarding simulation training in undergraduate health Sciences

BACKGROUND: Simulation techniques are spreading rapidly in medicine. Suc h resources are increasingly concentrated in Simulation Laboratories. The MSRP-USP is structuring such a laboratory and is interested in the prevalence of individual initiatives that could be centralized there. The MSRP-USP currently has five full-curriculum courses in the health sciences: Medicine, Speech Therapy, Physical Therapy, Nutrition, and Occupational Therapy, all consisting of core disciplines. GOAL: To determine the prevalence of simulation techniques in the regular courses at MSRP-USP. METHODS: Coordinators of disciplines in the various courses were interviewed using a specifically designed semi-structured questionnaire, and all the collected data were stored in a dedicated database. The disciplines were grouped according to whether they used (GI) or did not use (GII) simulation resources. RESULTS AND DISCUSSION: 256 disciplines were analyzed, of which only 18.3% used simulation techniques, varying according to course: Medicine (24.7.3%), Occupational Therapy (23.0%), Nutrition (15.9%), Physical Therapy (9.8%), and Speech Therapy (9.1%). Computer simulation programs predominated (42.5%) in all five courses. The resources were provided mainly by MSRP-USP (56.3%), with additional funding coming from other sources based on individual initiatives. The same pattern was observed for maintenance. There was great interest in centralizing the resources in the new Simulation Laboratory in order to facilitate maintenance, but there was concern about training and access to the material. CONCLUSIONS: 1) The MSRP-USP simulation resources show low complexity and are mainly limited to computer programs; 2) Use of simulation varies according to course, and is most prevalent in Medicine; 3) Resources are scattered across several locations, and their acquisition and maintenance depend on individual initiatives rather than central coordination or curricular guidelines