Financial impact of the Medicare prospective payment system on long term acute care hospitals

Objective. Long Term Acute Care Hospitals (LTACs) are subject to Medicare rules because they accept Medicare and Medicaid patients. In October 2002, Medicare changed the LTAC reimbursement formulas, from a cost basis system to a Prospective Payment System (PPS). This study examines whether the PPS has negatively affected the financial performance of the LTAC hospitals in the period following the reimbursement change (2003–2006), as compared to the period prior to the change (1999–2003), and if so, to what extent. This study will also examine whether the PPS has resulted in a decreased average patient length of stay (LOS) in the LTAC hospitals for the period of 2003–2006 as compared to the prior period of 1999-2003, and if so, to what extent. ^ Methods. The study group consists of two large LTAC hospital systems, Kindred Healthcare Inc. and Select Specialty Hospitals of Select Medical Corporation. Financial data and operational indicators were reviewed, tabulated and dichotomized into two groups, covering the two periods: 1999–2002 and 2003–2006. The financial data included net annual revenues, net income, revenue per patient per day and profit margins. It was hypothesized that the profit margins for the LTAC hospitals were reduced because of the new PPS. Operational indicators, such as annual admissions, annual patient days, and average LOS were analyzed. It was hypothesized that LOS for the LTAC hospitals would have decreased. Case mix index, defined as the weighted average of patients’ DRGs for each hospital system, was not available to cast more light on the direction of LOS. ^ Results. This assessment found that the negative financial impacts did not materialize; instead, financial performance improved during the PPS period (2003–2006). The income margin percentage under the PPS increased for Kindred by 24%, and for Select by 77%. Thus, the study’s working hypothesis of reduced income margins for the LTACs under the PPS was contradicted. As to the average patient length of stay, LOS decreased from 34.7 days to 29.4 days for Kindred, and from 30.5 days to 25.3 days for Select. Thus, on the issue of LTAC shorter length of stay, the study’s working hypothesis was confirmed. ^ Conclusion. Overall, there was no negative financial effect on the LTAC hospitals during the period of 2003–2006 following Medicare implementation of the PPS in October 2002. On the contrary, the income margins improved significantly. ^ During the same period, LOS decreased following the implementation of the PPS. This was consistent with the LTAC hospitals’ pursuit of financial incentives. ^

Metabolic syndrome in Mexican American females---prevalence and impact of age, socioeconomic status, and family history of type II diabetes

This thesis presents an analysis of data from Molecular Epidemiology of Type II Diabetes Mellitus in Mexican Americans. The study included 294 families. Among the participating families were 500 Mexican American females aged 19 to 86 who provided information on characteristics such as height, weight, and a variety of biochemical indicators. The research questions for this thesis are: (1) How strong is the association between indicators of the metabolic syndrome in study participants and their family histories of type II diabetes; and (2) How is an individual's family history of type II diabetes, age and socioeconomic status associated with the metabolic syndrome? In this thesis education status of the participants is used as an indicator of socioeconomic status. Answers to these questions are provided through the analysis of women's responses to written questionnaires and biochemical data. ^

Territorial quality and sustainable development : Indicators of performance in the context of a model for participatory rural tourism certification

El turismo rural ha sido incorporado por pequeños establecimientos agropecuarios del partido de Cnel. Suárez, provincia de Buenos Aires, Argentina, como actividad alternativa para mejorar la calidad de vida de sus miembros y superar situaciones de crisis agravadas por la marginalidad productiva del SO bonaerense, región a la que pertenecen. Bajo el programa Cambio Rural del INTA (Instituto Nacional de Tecnología Agropecuaria) conforman el Grupo 'Cortaderas II', junto a otros emprendedores interesados en valorar el medio rural. Han avanzado en el proceso de reconocimiento de su identidad y puesta en valor de recursos específicos con anclaje en el territorio. Esta identidad comienza a apreciarse internamente, a raíz de la dinámica grupal lograda y la incipiente articulación con otros actores para la construcción de un partenariado público y privado que genere sinergias y contribuya al desarrollo sustentable del territorio. Sin embargo, aún no es claramente percibida por el turista, cada vez más exigente. Por lo tanto, el presente trabajo persigue proponer indicadores para evaluar el desempeño de un Sistema de Gestión de Calidad con enfoque territorial que, adaptando el modelo europeo 'Marca de Calidad Territorial', sustente una estrategia comercial de diferenciación del servicio y simultáneamente, mida el progreso hacia una mejor calidad de vida y fortalecimiento de vínculos con la cultura local y el entorno físico-natural en el marco del desarrollo sustentable. La investigación se plantea para la micro escala, ya que se trata de un estudio de caso, relevándose información primaria mediante observación directa y entrevistas semi-estructuradas, complementada con información secundaria diagnóstica utilizada por INTA. Las características del grupo y su dinámica de funcionamiento bajo el programa Cambio Rural revelan que es posible adoptar un proceso de certificación participativa propuesto para cuatro pilares de la calidad: de Bienes y Servicios, Institucional, Social y Ambiental. El modelo se integra con indicadores de evaluación de desempeño, agrupados en áreas clave para cada una de las dimensiones de la sustentabilidad, que contemplan el paisaje y la gestión de los recursos naturales; el impacto económico de la actividad, la calidad de la oferta y satisfacción del turista; así como las relaciones sociales internas y los vínculos con otros actores del territorio. Principalmente se encontraron fortalezas en la búsqueda de partenariados y debilidades en aspectos de comunicación y promoción. Se considera que este sistema de herramientas de gestión sustentable permitiría superar las dificultades de una certificación individual, pudiendo aplicarse a emprendimientos con otra ubicación geográfica

Territorial quality and sustainable development : Indicators of performance in the context of a model for participatory rural tourism certification

El turismo rural ha sido incorporado por pequeños establecimientos agropecuarios del partido de Cnel. Suárez, provincia de Buenos Aires, Argentina, como actividad alternativa para mejorar la calidad de vida de sus miembros y superar situaciones de crisis agravadas por la marginalidad productiva del SO bonaerense, región a la que pertenecen. Bajo el programa Cambio Rural del INTA (Instituto Nacional de Tecnología Agropecuaria) conforman el Grupo 'Cortaderas II', junto a otros emprendedores interesados en valorar el medio rural. Han avanzado en el proceso de reconocimiento de su identidad y puesta en valor de recursos específicos con anclaje en el territorio. Esta identidad comienza a apreciarse internamente, a raíz de la dinámica grupal lograda y la incipiente articulación con otros actores para la construcción de un partenariado público y privado que genere sinergias y contribuya al desarrollo sustentable del territorio. Sin embargo, aún no es claramente percibida por el turista, cada vez más exigente. Por lo tanto, el presente trabajo persigue proponer indicadores para evaluar el desempeño de un Sistema de Gestión de Calidad con enfoque territorial que, adaptando el modelo europeo 'Marca de Calidad Territorial', sustente una estrategia comercial de diferenciación del servicio y simultáneamente, mida el progreso hacia una mejor calidad de vida y fortalecimiento de vínculos con la cultura local y el entorno físico-natural en el marco del desarrollo sustentable. La investigación se plantea para la micro escala, ya que se trata de un estudio de caso, relevándose información primaria mediante observación directa y entrevistas semi-estructuradas, complementada con información secundaria diagnóstica utilizada por INTA. Las características del grupo y su dinámica de funcionamiento bajo el programa Cambio Rural revelan que es posible adoptar un proceso de certificación participativa propuesto para cuatro pilares de la calidad: de Bienes y Servicios, Institucional, Social y Ambiental. El modelo se integra con indicadores de evaluación de desempeño, agrupados en áreas clave para cada una de las dimensiones de la sustentabilidad, que contemplan el paisaje y la gestión de los recursos naturales; el impacto económico de la actividad, la calidad de la oferta y satisfacción del turista; así como las relaciones sociales internas y los vínculos con otros actores del territorio. Principalmente se encontraron fortalezas en la búsqueda de partenariados y debilidades en aspectos de comunicación y promoción. Se considera que este sistema de herramientas de gestión sustentable permitiría superar las dificultades de una certificación individual, pudiendo aplicarse a emprendimientos con otra ubicación geográfica

Territorial quality and sustainable development : Indicators of performance in the context of a model for participatory rural tourism certification

El turismo rural ha sido incorporado por pequeños establecimientos agropecuarios del partido de Cnel. Suárez, provincia de Buenos Aires, Argentina, como actividad alternativa para mejorar la calidad de vida de sus miembros y superar situaciones de crisis agravadas por la marginalidad productiva del SO bonaerense, región a la que pertenecen. Bajo el programa Cambio Rural del INTA (Instituto Nacional de Tecnología Agropecuaria) conforman el Grupo 'Cortaderas II', junto a otros emprendedores interesados en valorar el medio rural. Han avanzado en el proceso de reconocimiento de su identidad y puesta en valor de recursos específicos con anclaje en el territorio. Esta identidad comienza a apreciarse internamente, a raíz de la dinámica grupal lograda y la incipiente articulación con otros actores para la construcción de un partenariado público y privado que genere sinergias y contribuya al desarrollo sustentable del territorio. Sin embargo, aún no es claramente percibida por el turista, cada vez más exigente. Por lo tanto, el presente trabajo persigue proponer indicadores para evaluar el desempeño de un Sistema de Gestión de Calidad con enfoque territorial que, adaptando el modelo europeo 'Marca de Calidad Territorial', sustente una estrategia comercial de diferenciación del servicio y simultáneamente, mida el progreso hacia una mejor calidad de vida y fortalecimiento de vínculos con la cultura local y el entorno físico-natural en el marco del desarrollo sustentable. La investigación se plantea para la micro escala, ya que se trata de un estudio de caso, relevándose información primaria mediante observación directa y entrevistas semi-estructuradas, complementada con información secundaria diagnóstica utilizada por INTA. Las características del grupo y su dinámica de funcionamiento bajo el programa Cambio Rural revelan que es posible adoptar un proceso de certificación participativa propuesto para cuatro pilares de la calidad: de Bienes y Servicios, Institucional, Social y Ambiental. El modelo se integra con indicadores de evaluación de desempeño, agrupados en áreas clave para cada una de las dimensiones de la sustentabilidad, que contemplan el paisaje y la gestión de los recursos naturales; el impacto económico de la actividad, la calidad de la oferta y satisfacción del turista; así como las relaciones sociales internas y los vínculos con otros actores del territorio. Principalmente se encontraron fortalezas en la búsqueda de partenariados y debilidades en aspectos de comunicación y promoción. Se considera que este sistema de herramientas de gestión sustentable permitiría superar las dificultades de una certificación individual, pudiendo aplicarse a emprendimientos con otra ubicación geográfica

Modelling the Impact of Built Environment, Geographical Scales and Latent Constructs On Individual Travel Behaviour

La relación entre la estructura urbana y la movilidad ha sido estudiada desde hace más de 70 años. El entorno urbano incluye múltiples dimensiones como por ejemplo: la estructura urbana, los usos de suelo, la distribución de instalaciones diversas (comercios, escuelas y zonas de restauración, parking, etc.). Al realizar una revisión de la literatura existente en este contexto, se encuentran distintos análisis, metodologías, escalas geográficas y dimensiones, tanto de la movilidad como de la estructura urbana. En este sentido, se trata de una relación muy estudiada pero muy compleja, sobre la que no existe hasta el momento un consenso sobre qué dimensión del entorno urbano influye sobre qué dimensión de la movilidad, y cuál es la manera apropiada de representar esta relación. Con el propósito de contestar estas preguntas investigación, la presente tesis tiene los siguientes objetivos generales: (1) Contribuir al mejor entendimiento de la compleja relación estructura urbana y movilidad. y (2) Entender el rol de los atributos latentes en la relación entorno urbano y movilidad. El objetivo específico de la tesis es analizar la influencia del entorno urbano sobre dos dimensiones de la movilidad: número de viajes y tipo de tour. Vista la complejidad de la relación entorno urbano y movilidad, se pretende contribuir al mejor entendimiento de la relación a través de la utilización de 3 escalas geográficas de las variables y del análisis de la influencia de efectos inobservados en la movilidad. Para el análisis se utiliza una base de datos conformada por tres tipos de datos: (1) Una encuesta de movilidad realizada durante los años 2006 y 2007. Se obtuvo un total de 943 encuestas, en 3 barrios de Madrid: Chamberí, Pozuelo y Algete. (2) Información municipal del Instituto Nacional de Estadística: dicha información se encuentra enlazada con los orígenes y destinos de los viajes recogidos en la encuesta. Y (3) Información georeferenciada en Arc-GIS de los hogares participantes en la encuesta: la base de datos contiene información respecto a la estructura de las calles, localización de escuelas, parking, centros médicos y lugares de restauración. Se analizó la correlación entre e intra-grupos y se modelizaron 4 casos de atributos bajo la estructura ordinal logit. Posteriormente se evalúa la auto-selección a través de la estimación conjunta de las elecciones de tipo de barrio y número de viajes. La elección del tipo de barrio consta de 3 alternativas: CBD, Urban y Suburban, según la zona de residencia recogida en las encuestas. Mientras que la elección del número de viajes consta de 4 categorías ordinales: 0 viajes, 1-2 viajes, 3-4 viajes y 5 o más viajes. A partir de la mejor especificación del modelo ordinal logit. Se desarrolló un modelo joint mixed-ordinal conjunto. Los resultados indican que las variables exógenas requieren un análisis exhaustivo de correlaciones con el fin de evitar resultados sesgados. ha determinado que es importante medir los atributos del BE donde se realiza el viaje, pero también la información municipal es muy explicativa de la movilidad individual. Por tanto, la percepción de las zonas de destino a nivel municipal es considerada importante. En el contexto de la Auto-selección (self-selection) es importante modelizar conjuntamente las decisiones. La Auto-selección existe, puesto que los parámetros estimados conjuntamente son significativos. Sin embargo, sólo ciertos atributos del entorno urbano son igualmente importantes sobre la elección de la zona de residencia y frecuencia de viajes. Para analizar la Propensión al Viaje, se desarrolló un modelo híbrido, formado por: una variable latente, un indicador y un modelo de elección discreta. La variable latente se denomina “Propensión al Viaje”, cuyo indicador en ecuación de medida es el número de viajes; la elección discreta es el tipo de tour. El modelo de elección consiste en 5 alternativas, según la jerarquía de actividades establecida en la tesis: HOME, no realiza viajes durante el día de estudio, HWH tour cuya actividad principal es el trabajo o estudios, y no se realizan paradas intermedias; HWHs tour si el individuo reaiza paradas intermedias; HOH tour cuya actividad principal es distinta a trabajo y estudios, y no se realizan paradas intermedias; HOHs donde se realizan paradas intermedias. Para llegar a la mejor especificación del modelo, se realizó un trabajo importante considerando diferentes estructuras de modelos y tres tipos de estimaciones. De tal manera, se obtuvieron parámetros consistentes y eficientes. Los resultados muestran que la modelización de los tours, representa una ventaja sobre la modelización de los viajes, puesto que supera las limitaciones de espacio y tiempo, enlazando los viajes realizados por la misma persona en el día de estudio. La propensión al viaje (PT) existe y es específica para cada tipo de tour. Los parámetros estimados en el modelo híbrido resultaron significativos y distintos para cada alternativa de tipo de tour. Por último, en la tesis se verifica que los modelos híbridos representan una mejora sobre los modelos tradicionales de elección discreta, dando como resultado parámetros consistentes y más robustos. En cuanto a políticas de transporte, se ha demostrado que los atributos del entorno urbano son más importantes que los LOS (Level of Service) en la generación de tours multi-etapas. la presente tesis representa el primer análisis empírico de la relación entre los tipos de tours y la propensión al viaje. El concepto Propensity to Travel ha sido desarrollado exclusivamente para la tesis. Igualmente, el desarrollo de un modelo conjunto RC-Number of trips basado en tres escalas de medida representa innovación en cuanto a la comparación de las escalas geográficas, que no había sido hecha en la modelización de la self-selection. The relationship between built environment (BE) and travel behaviour (TB) has been studied in a number of cases, using several methods - aggregate and disaggregate approaches - and different focuses – trip frequency, automobile use, and vehicle miles travelled and so on. Definitely, travel is generated by the need to undertake activities and obtain services, and there is a general consensus that urban components affect TB. However researches are still needed to better understand which components of the travel behaviour are affected most and by which of the urban components. In order to fill the gap in the research, the present dissertation faced two main objectives: (1) To contribute to the better understanding of the relationship between travel demand and urban environment. And (2) To develop an econometric model for estimating travel demand with urban environment attributes. With this purpose, the present thesis faced an exhaustive research and computation of land-use variables in order to find the best representation of BE for modelling trip frequency. In particular two empirical analyses are carried out: 1. Estimation of three dimensions of travel demand using dimensions of urban environment. We compare different travel dimensions and geographical scales, and we measure self-selection contribution following the joint models. 2. Develop a hybrid model, integrated latent variable and discrete choice model. The implementation of hybrid models is new in the analysis of land-use and travel behaviour. BE and TB explicitly interact and allow richness information about a specific individual decision process For all empirical analysis is used a data-base from a survey conducted in 2006 and 2007 in Madrid. Spatial attributes describing neighbourhood environment are derived from different data sources: National Institute of Statistics-INE (Administrative: municipality and district) and GIS (circular units). INE provides raw data for such spatial units as: municipality and district. The construction of census units is trivial as the census bureau provides tables that readily define districts and municipalities. The construction of circular units requires us to determine the radius and associate the spatial information to our households. The first empirical part analyzes trip frequency by applying an ordered logit model. In this part is studied the effect of socio-economic, transport and land use characteristics on two travel dimensions: trip frequency and type of tour. In particular the land use is defined in terms of type of neighbourhoods and types of dwellers. Three neighbourhood representations are explored, and described three for constructing neighbourhood attributes. In particular administrative units are examined to represent neighbourhood and circular – unit representation. Ordered logit models are applied, while ordinal logit models are well-known, an intensive work for constructing a spatial attributes was carried out. On the other hand, the second empirical analysis consists of the development of an innovative econometric model that considers a latent variable called “propensity to travel”, and choice model is the choice of type of tour. The first two specifications of ordinal models help to estimate this latent variable. The latent variable is unobserved but the manifestation is called “indicators”, then the probability of choosing an alternative of tour is conditional to the probability of latent variable and type of tour. Since latent variable is unknown we fit the integral over its distribution. Four “sets of best variables” are specified, following the specification obtained from the correlation analysis. The results evidence that the relative importance of SE variables versus BE variables depends on how BE variables are measured. We found that each of these three spatial scales has its intangible qualities and drawbacks. Spatial scales play an important role on predicting travel demand due to the variability in measures at trip origin/destinations within the same administrative unit (municipality, district and so on). Larger units will produce less variation in data; but it does not affect certain variables, such as public transport supply, that are more significant at municipality level. By contrast, land-use measures are more efficient at district level. Self-selection in this context, is weak. Thus, the influence of BE attributes is true. The results of the hybrid model show that unobserved factors affect the choice of tour complexity. The latent variable used in this model is propensity to travel that is explained by socioeconomic aspects and neighbourhood attributes. The results show that neighbourhood attributes have indeed a significant impact on the choice of the type of tours either directly and through the propensity to travel. The propensity to travel has a different impact depending on the structure of each tour and increases the probability of choosing more complex tours, such as tours with many intermediate stops. The integration of choice and latent variable model shows that omitting important perception and attitudes leads to inconsistent estimates. The results also indicate that goodness of fit improves by adding the latent variable in both sequential and simultaneous estimation. There are significant differences in the sensitivity to the latent variable across alternatives. In general, as expected, the hybrid models show a major improvement into the goodness of fit of the model, compared to a classical discrete choice model that does not incorporate latent effects. The integrated model leads to a more detailed analysis of the behavioural process. Summarizing, the effect that built environment characteristics on trip frequency studied is deeply analyzed. In particular we tried to better understand how land use characteristics can be defined and measured and which of these measures do have really an impact on trip frequency. We also tried to test the superiority of HCM on this field. We can concluded that HCM shows a major improvement into the goodness of fit of the model, compared to classical discrete choice model that does not incorporate latent effects. And consequently, the application of HCM shows the importance of LV on the decision of tour complexity. People are more elastic to built environment attributes than level of services. Thus, policy implications must take place to develop more mixed areas, work-places in combination with commercial retails.

Approach to the use of indicators for the assessment of the environmental level of construction products

The European construction industry is supposed to consume the 40% of the natural European resources and to generate the 40% of the European solid waste. Conscious of the great damage being suffered by the environment because of construction activity, this work tries to provide the building actors with a new tool to improve the current situation. The tool proposed is a model for the comprehensive evaluation of construction products by determining their environmental level. In this research, the environmental level of a construction product has been defined as its quality of accomplishing the construction requirements needed by causing the minimum ecological impact in its surrounding environment. This information allows building actors to choose suitable materials for building needs and also for the environment, mainly in the project stage or on the building site, contributing to improve the relationship between buildings and environment. For the assessment of the environmental level of construction products, five indicators have been identified regarding their global environmental impact through the product life cycle: CO2 emissions provoked during their production, volume and toxicity of waste generated on the building site, durability and recycling capacity after their useful life. Therefore, the less environmental impact one construction product produces, the higher environmental level performs. The model has been tested in 30 construction products that include environmental criteria in their description. The results obtained will be discussed in this article. Furthermore, this model can lay down guidelines for the selection of ecoefficient construction products and the design of new eco-competitive and eco-committed ones

Traditional education vs modern education. What is the impact of teaching techniques' evolution on students learning process?

The main objective of this article is to focus on the analysis of teaching techniques, ranging from the use of the blackboard and chalk in old traditional classes, using slides and overhead projectors in the eighties and use of presentation software in the nineties, to the video, electronic board and network resources nowadays. Furthermore, all the aforementioned, is viewed under the different mentalities in which the teacher conditions the student using the new teaching technique, improving soft skills but maybe leading either to encouragement or disinterest, and including the lack of educational knowledge consolidation at scientific, technology and specific levels. In the same way, we study the process of adaptation required for teachers, the differences in the processes of information transfer and education towards the student, and even the existence of teachers who are not any longer appealed by their work due which has become much simpler due to new technologies and the greater ease in the development of classes due to the criteria described on the new Grade Programs adopted by the European Higher Education Area. Moreover, it is also intended to understand the evolution of students’ profiles, from the eighties to present time, in order to understand certain attitudes, behaviours, accomplishments and acknowledgements acquired over the semesters within the degree Programs. As an Educational Innovation Group, another key question also arises. What will be the learning techniques in the future?. How these evolving matters will affect both positively and negatively on the mentality, attitude, behaviour, learning, achievement of goals and satisfaction levels of all elements involved in universities’ education? Clearly, this evolution from chalk to the electronic board, the three-dimensional view of our works and their sequence, greatly facilitates the understanding and adaptation later on to the business world, but does not answer to the unknowns regarding the knowledge and the full development of achievement’s indicators in basic skills of a degree. This is the underlying question which steers the roots of the presented research.

Assessing the impact of adaptive accessibility on the optimal transport policy implementation by using an integrated land-use/transport model for Madrid

Accessibility is an essential concept widely used to evaluate the impact of land-use and transport strategies in transport and urban planning. Accessibility is typically evaluated by using a transport model or a land-use model independently or successively without a feedback loop, thus neglecting the interaction effects between the two systems and the induced competition effects among opportunities due to accessibility improvements. More than a mere methodological curiosity, failure to account for land- use/transport interactions and the competition effect may result in large underestimation of the policy effects. With the recent development of land-use and transport interaction (LUTI) models, there is a growing interest in using these models to adequately measure accessibility and evaluate its impact. The current study joins this research stream by embedding an accessibility measure in a LUTI model with two main aims. The first aim is to account for adaptive accessibility, namely the adjustment of the potential accessibility due to the effect of competition among opportunities (e.g., workplaces) as a result of improved accessibility. LUTI models are particularly suitable for assessing adaptive accessibility because the competition factor is a function of the number of jobs, which is related to land-use attractiveness and the number of workers which is related, among other factors, to the transport demand. The second aim is to identify the optimal implementation scenario of policy measures on the basis of the potential and adaptive accessibility and analyse the results in terms of social welfare and accessibility. The metropolitan area of Madrid is used as a case-study and two transport policy instruments, namely a cordon toll and bus frequency increase, have been chosen for the simulation study in order to present the usefulness of the approach to urban planners and policy makers. The MARS model (Metropolitan Activity Relocation Simulator) calibrated for Madrid was employed as the analysis tool. The impact of accessibility is embedded in the model through a social welfare function that includes not only costs and benefits to both road users and transport operators, but also costs and benefits for the government and society in general (external costs). An optimisation procedure is performed by the MARS model for maximizing the value of objective function in order to find the best (optimal) policy imp lementations intensity (i.e., price, frequency). Last, the two policy strategies are evaluated in terms of their accessibility. Results show that the accessibility with competition factor influences the optimal policy implementation level and also generates different results in terms of social welfare. In addition, mapping the difference between the potential and the adaptive accessibility indicators shows that the main changes occur in areas where there is a strong competition among land-use opportunities.

Assessment of innovative measures implemented in European bus systems using key performance indicators

This paper reports the results of the assessment of a range of measures implemented in bus systems in five European cities to improve the use of public transport by increasing its attractiveness and enhancing its image in urban areas. This research was conducted as part of the EBSF project (European Bus System of the Future) from 2008 to 2012. New buses (prototypes), new vehicle and infrastructure technologies, and operational best practices were introduced, all of which were combined in a system approach. The measures were assessed using multicriteria analysis to simultaneously evaluate a certain number of criteria that need to be aggregated. Each criterion is measured by one or more key performance indicators (KPI) calculated in two scenarios (reference scenario, with no measure implemented; and project scenario, with the implementation of some measures), in order to evaluate the difference in the KPI performance between the reference and project scenario. The results indicate that the measures produce a greater benefit in issues related to bus system productivity and customer satisfaction, with the greatest impact on aspects of perceptions of comfort, cleanliness and quality of service, information to passengers and environmental issues. The study also reveals that the implementation of several measures has greater social utility than very specific and isolated measures.

Analysis of the impact of globalization and economic growth on food security in developing countries

A pesar de los importantes avances en la reducción del hambre, la seguridad alimentaria continúa siendo un reto de dimensión internacional. La seguridad alimentaria es un concepto amplio y multidimensional, cuyo análisis abarca distintas escalas y horizontes temporales. Dada su complejidad, la identificación de las causas de la inseguridad alimentaria y la priorización de las medias para abordarlas, son dos cuestiones que suscitan un intenso debate en la actualidad. El objetivo de esta tesis es evaluar el impacto de la globalización y el crecimiento económico en la seguridad alimentaria en los países en desarrollo, desde una perspectiva macro y un horizonte temporal a largo plazo. La influencia de la globalización se aborda de una manera secuencial. En primer lugar, se analiza la relación entre la inversión público-privada en infraestructuras y las exportaciones agrarias. A continuación, se estudia el impacto de las exportaciones agrarias en los indicadores de seguridad alimentaria. El estudio del impacto del crecimiento económico aborda los cambios paralelos en la distribución de la renta, y cómo la inequidad influye en el comportamiento de la seguridad alimentaria nacional. Además, se analiza en qué medida el crecimiento económico contribuye a acelerar el proceso de mejora de la seguridad alimentaria. Con el fin de conseguir los objetivos mencionados, se llevan a cabo varios análisis econométricos basados en datos de panel, en el que se combinan datos de corte transversal de 52 países y datos temporales comprendidos en el periodo 1991-2012. Se analizan tanto variables en niveles como variables en tasas de cambio anual. Se aplican los modelos de estimación de efectos variables y efectos fijos, ambos en niveles y en primeras diferencias. La tesis incluye cuatro tipos de modelos econométricos, cada uno de ellos con sus correspondientes pruebas de robustez y especificaciones. Los resultados matizan la importancia de la globalización y el crecimiento económico como mecanismos de mejora de la seguridad alimentaria en los países en desarrollo. Se obtienen dos conclusiones relativas a la globalización. En primer lugar, los resultados sugieren que la promoción de las inversiones privadas en infraestructuras contribuye a aumentar las exportaciones agrarias. En segundo lugar, se observa que las exportaciones agrarias pueden tener un impacto negativo en los indicadores de seguridad alimentaria. La combinación de estas dos conclusiones sugiere que la apertura comercial y financiera no contribuye por sí misma a la mejora de la seguridad alimentaria en los países en desarrollo. La apertura internacional de los países en desarrollo ha de ir acompañada de políticas e inversiones que desarrollen sectores productivos de alto valor añadido, que fortalezcan la economía nacional y reduzcan su dependencia exterior. En relación al crecimiento económico, a pesar del incuestionable hecho de que el crecimiento económico es una condición necesaria para reducir los niveles de subnutrición, no es una condición suficiente. Se han identificado tres estrategias adicionales que han de acompañar al crecimiento económico con el fin de intensificar su impacto positivo sobre la subnutrición. Primero, es necesario que el crecimiento económico sea acompañado de una distribución más equitativa de los ingresos. Segundo, el crecimiento económico ha de reflejarse en un aumento de inversiones en salud, agua y saneamiento y educación. Se observa que, incluso en ausencia de crecimiento económico, mejoras en el acceso a agua potable contribuyen a reducir los niveles de población subnutrida. Tercero, el crecimiento económico sostenible en el largo plazo parece tener un mayor impacto positivo sobre la seguridad alimentaria que el crecimiento económico más volátil o inestable en el corto plazo. La estabilidad macroeconómica se identifica como una condición necesaria para alcanzar una mayor mejora en la seguridad alimentaria, incluso habiéndose mejorado la equidad en la distribución de los ingresos. Por último, la tesis encuentra que los países en desarrollo analizados han experimentado diferentes trayectorias no lineales en su proceso de mejora de sus niveles de subnutrición. Los resultados sugieren que un mayor nivel inicial de subnutrición y el crecimiento económico son responsables de una respuesta más rápida al reto de la mejora de la seguridad alimentaria. ABSTRACT Despite the significant reductions of hunger, food security still remains a global challenge. Food security is a wide concept that embraces multiple dimensions, and has spatial-temporal scales. Because of its complexity, the identification of the drivers underpinning food insecurity and the prioritization of measures to address them are a subject of intensive debate. This thesis attempts to assess the impact of globalization and economic growth on food security in developing countries with a macro level scale (country) and using a long-term approach. The influence of globalization is addressed in a sequential way. First, the impact of public-private investment in infrastructure on agricultural exports in developing countries is analyzed. Secondly, an assessment is conducted to determine the impact of agricultural exports on food security indicators. The impact of economic growth focuses on the parallel changes in income inequality and how the income distribution influences countries' food security performance. Furthermore, the thesis analyzes to what extent economic growth helps accelerating food security improvements. To address the above mentioned goals, various econometric models are formulated. Models use panel data procedures combining cross-sectional data of 52 countries and time series data from 1991 to 2012. Yearly data are expressed both in levels and in changes. The estimation models applied are random effects estimation and fixed effects estimations, both in levels and in first differences. The thesis includes four families of econometric models, each with its own set of robustness checks and specifications. The results qualify the relevance of globalization and economic growth as enabling mechanisms for improving food security in developing countries. Concerning globalization, two main conclusions can be drawn. First, results showed that enhancing foreign private investment in infrastructures contributes to increase agricultural exports. Second, agricultural exports appear to have a negative impact on national food security indicators. These two conclusions suggest that trade and financial openness per se do not contribute directly to improve food security in development countries. Both measures should be accompanied by investments and policies to support the development of national high value productive sectors, to strengthen the domestic economy and reduce its external dependency. Referring to economic growth, despite the unquestionable fact that income growth is a pre-requisite for reducing undernourishment, results suggest that it is a necessary but not a sufficient condition. Three additional strategies should accompany economic growth to intensifying its impact on food security. Firstly, it is necessary that income growth should be accompanied by a better distribution of income. Secondly, income growth needs to be followed by investments and policies in health, sanitation and education to improve food security. Even if economic growth falters, sustained improvements in the access to drinking water may still give rise to reductions in the percentage of undernourished people. And thirdly, long-term economic growth appears to have a greater impact on reducing hunger than growth regimes that combine periods of growth peaks followed by troughs. Macroeconomic stability is a necessary condition for accelerating food security. Finally, the thesis finds that the developing countries analyzed have experienced different non-linear paths toward improving food security. Results also show that a higher initial level of undernourishment and economic growth result in a faster response for improving food security.

Assessing the accessibility impact of transport policy by a land-use and transport interaction model - The case of Madrid

Accessibility is an essential concept widely used to evaluate the impact of transport and land-use strategies in urban planning and policy making. Accessibility is typically evaluated by using separately a transport model or a land-use model. This paper embeds two accessibility indicators (i.e., potential and adaptive accessibility) in a land use and transport interaction (LUTI) model in order to assess transport policies implementation. The first aim is to define the adaptive accessibility, considering the competition factor at territorial level (e.g. workplaces and workers). The second aim is to identify the optimal implementation scenario of policy measures using potential and adaptive accessibility indicators. The analysis of the results in terms of social welfare and accessibility changes closes the paper. Two transport policy measures are applied in Madrid region: a cordon toll and increase bus frequency. They have been simulated through the MARS model (Metropolitan Activity Relocation Simulator, i.e. LUTI model). An optimisation procedure is performed by MARS for maximizing the value of the objective function in order to find the optimal policy implementation (first best). Both policy measures are evaluated in terms of accessibility. Results show that the introduction of the accessibility indicators (potential and adaptive) influence the optimal value of the toll price and bus frequency level, generating different results in terms of social welfare. Mapping the difference between potential and adaptive accessibility indicator shows that the main changes occur in areas where there is a strong competition among different land-use opportunities.

Leading Safety Indicators: Proactively Monitoring Safety Performance

Traditional measures or indicators of workplace safety performance reflect unrecognized hazards, unsafe conditions, reckless behavior, and other safety program shortcomings only after a worker is injured or falls ill. In contrast to traditional or lagging indicators, leading indicators can predict poor safety performance to ensure that safety program failings are addressed before an occupational injury or illness actually occurs. This Capstone Project identified a variety of proactive safety management practices, policies, and activities shown to have a positive impact on workplace safety as leading safety indicators. The end result is a comprehensive framework of leading safety indicators that employers can use to proactively gauge safety program performance and address unrecognized hazards, unsafe conditions, reckless behavior, and other safety program deficiencies.

The Universality of Civil War Definitions: A Study of How Regional Considerations Impact Civil War in Somalia, Colombia, and Angola

Civil war is a socially intimate phenomenon. The viability of the conflict hinges on recruitment for the cause, military strategy, community support, and a variety of other conditional factors. Despite this dependence on local society, many researchers approach civil war from a global perspective, attempting to discover universal truths about this kind of conflict. This capstone project focuses on restricting the operating parameters of civil war research projects to the span of a single continent, hoping to achieve deeper insight by focusing the research using a more culturally sensitive set of parameters. By using cultural data to guide civil war research, conflict indicators can tailor conflict prevention to escalating violent scenarios.

Poor and under pressure: the social impact of Europe's fiscal consolidation. Bruegel Policy Contribution, Issue 2015/04, March 2015

Europe faces major challenges related to poverty, unemployment and polarisation between the south and the north, which impact adversely the current living conditions of many citizens, and also negatively impact medium- and long-term economic growth. Fiscal consolidation exaggerated social hardship. In vulnerable countries there was no alternative to fiscal consolidation, but in most EU countries and at aggregate EU level, consolidation was premature when the cyclical position of the economy was deteriorating. Spending on social protection was shielded relative to other spending categories, but public bank rescue costs were high. While the changes in the tax mix favoured job creation, the overall tax burden become more regressive. There is an increasing generational divide between the elderly and the young in terms of social indicators. Social spending on elderly people was favoured relative to spending on families, children and education. There is now a serious danger that a lost generation might develop in several member states. Forceful policies should include bold structural reforms, better use of the European economic governance framework, more demand promotion, and a revision of national tax/benefit systems for fair burden sharing between the wealthy and poor.