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Climate change poses significant risks to health and health systems, with the greatest impacts in low- and middle-income countries - which are least responsible for greenhouse gas emissions. The Conference of Parties 28 at the 2023 United Nations Climate Change Conference led to agreement on the need for holistic and equitable financing approaches to address the climate and health crisis. This paper provides an overview of existing climate finance mechanisms - that is, multilateral funds, voluntary market-based mechanisms, taxes, microlevies and adaptive social protection. We discuss these approaches' potential use to promote health, generate additional health sector resources and enhance health system sustainability and resilience, and also explore implementation challenges. We suggest that public health practitioners, policy-makers and researchers seize the opportunity to leverage climate funding for better health and sustainable, climate-resilient health systems. Emphasizing the wider benefits of investing in health for the economy can help prioritize health within climate finance initiatives. Meaningful progress will require the global community acknowledging the underlying political economy challenges that have so far limited the potential of climate finance to address health goals. To address these challenges, we need to restructure financing institutions to empower communities at the frontline of the climate and health crisis and ensure their needs are met. Efforts from global and national level stakeholders should focus on mobilizing a wide range of funding sources, prioritizing co-design and accessibility of financing arrangements. These stakeholders should also invest in rigorous monitoring and evaluation of initiatives to ensure relevant health and well-being outcomes are addressed. [ABSTRACT FROM AUTHOR]

Home equity represents a substantial share of retirement wealth for many older persons, particularly in Asia where national housing policies have encouraged home-ownership. This paper explored the potential for reverse mortgages to help 'asset-rich and cash-poor' older Singaporeans unlock their home equity while ageing in place. The empirical analysis was based on a nationally representative survey of home-owners age 50+ in the 2018 Singapore Life Panel (N = 6,258). Our analyses showed that the average older home-owner holds some 60 per cent of total net wealth in housing equity, suggestive of high demand potential for reverse mortgage products. Nevertheless, actual interest in such products was much below potential demand. Only one in four older home-owners indicated interest in commercial reverse mortgages if these were to become available; a larger majority had never heard of the financial product. Interest in reverse mortgages was positively associated with product awareness and self-rated product understanding. This implies that a critical step towards building consumer interest would be to enhance awareness of such products and simplify related contract terms. Having a mortgage, fewer children, financial literacy and preparedness for retirement were also positively associated with interest level. These results have implications for targeted interventions to enhance consumer awareness and spur interest in reverse mortgages, especially in ageing societies where older people have built up substantial equity through the housing market over time. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is an established risk factor for cardiovascular and nephropathic events. In the Netherlands, prevalence of T2DM is expected to be as high as 8% by 2025. This will result in significant clinical and economic impact, highlighting the need for well-informed reimbursement decisions for new treatments. However, availability and consistent use of costing methodologies is limited. Objective: We aimed to systematically review recent costing data for T2DM-related cardiovascular and nephropathic events in the Netherlands. Methods: A systematic literature review in PubMed and Embase was conducted to identify available Dutch cost data for T2DM-related events, published in the last decade. Information extracted included costs, source, study population, and costing perspective. Finally, papers were evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). Results: Out of initially 570 papers, 36 agreed with the inclusion criteria. From these studies, 150 cost estimates for T2DM-related clinical events were identified. In total, 29 cost estimates were reported for myocardial infarction (range: €196-€27,038), 61 for stroke (€495-€54,678), fifteen for heart failure (€325-€16,561), 24 for renal failure (€2,438-€91,503), and seventeen for revascularisation (€3,000-€37,071). Only four estimates for transient ischaemic attack were available, ranging from €587 to €2,470. Adherence to CHEERS was generally high. Conclusions: The most expensive clinical events were related to renal failure, while TIA was the least expensive event. Generally, there was substantial variation in reported cost estimates for T2DM-related events. Costing of clinical events should be improved and preferably standardised, as accurate and consistent results in economic models are desired. [ABSTRACT FROM AUTHOR]

Many features of the U.S. political economy arise from the interactions between large political and economic institutions, and yet we know little about the nature of their interactions and the power distribution between these institutions. In this paper, we present a detailed analysis of networks of U.S.‐based organizations, where edges represent three different kinds of relationships, namely owner–owned (ownerships), donor–donee (donations), and service provider–payee (transactions). Our findings suggest that in the ownerships network, the financial organizations form the core, and banking organizations hold strategic locations in the network. In the transactions network, the government organizations and agencies form the core, and defense‐related organizations form the backbone. In contrast, with the donations network, no specific domain of organizations forms either the core or the backbone. [ABSTRACT FROM AUTHOR]

Motivation and method: Existing rational expectations models cannot satisfactorily explain why political budget manipulations systematically raise re-election chances and only occur in “specific contexts”. This paper offers a theoretical explanation by including unsophisticated voters into an opportunistic political cycle model; unsophisticated voters are unable to take the optimal behaviour of other agents (fully) into account, but may, nonetheless, vaguely suspect government deception. Results: First, rationally expected manipulations are, on average, fruitless in equilibrium. By including unsophisticated voters we can, however, corroborate empirically found electoral effects of political budget manipulations. Second, unsophisticated voters become anxious and suspicious in an intransparent or uncertain world, but the government tries to “outperform” their scepticism by increasing budget manipulations in order to appear more competent and, ultimately, increase re-election chances. It is, therefore, not surprising that political budget cycles are observed in countries suffering from intransparencies such as developing countries or new democracies. Third and in addition, the model presented here predicts that political opportunism produces, unintentionally, a countercyclical policy effect in election years, thereby, for instance, alleviating the typical problem of policy procyclicality in developing countries. Additional contribution: The paper also offers a theoretical explanation for political distortions found in forecasts by US states. Based on overly optimistic revenue forecasts the incumbent state government can conduct expansionary fiscal policies in order to appear more competent prior to an upcoming election. Since the resulting deficit can only be observed afterwards, the government can effectively circumvent a constitutional balanced budget constraint. As a result, there are political forecast and budget cycles in the state. More generally, however, these findings may also apply to European countries where balanced budget constraints are or will be in place (for instance the debt brakes in Switzerland and Germany); similarly, they apply to the supra-national European Fiscal Compact of the European Union. [ABSTRACT FROM AUTHOR]

Background: Over the past two decades, the focus of mental health care has shifted from institutionalisation to community-based programs and short hospital stays. This change means that there is an increased role for caregivers, mostly family members, in managing persons with mental illness. Although there is evidence to support the benefits of deinstitutionalisation of mental health care, there are also indications of substantial burden experienced by caregivers; the evidence of which is limited in sub-Saharan Africa. However, knowledge of the nature and extent of this burden can inform the planning of mental health services that will not only benefit patients, but also caregivers and households. Objective: To systematically review the available evidence on the economic burden of severe mental illness on primary family caregivers in sub-Saharan Africa. Methods: A comprehensive search was conducted in Pubmed, CINAHL, Econlit and Web of Science with no date limitations up to September 2016 using keywords such as "burden", "cost of illness" and "economic burden" to identify relevant published literature. Articles were appraised using a standardised data extraction tool covering themes such as physical, psychological and socioeconomic burden. Results: Seven papers were included in the review. Caregivers were mostly family members with a mean age of 46.34, female and unemployed. Five out of seven studies (71%) estimated the full economic burden of severe mental illness on caregivers. The remainder of studies just described the caregiver burden. All seven papers reported moderate to severe caregiver burden characterised by financial constraint, productivity loss and lost employment. The caregiver’s level of income and employment status, severity of patient's condition and duration of mental illness were reported to negatively affect the economic burden experienced by caregivers. Conclusion: There is paucity of studies reporting the burden of severe mental illness on caregivers in sub-Saharan Africa. Further research is needed to present the nature and extent of this burden to inform service planning and policymaking. [ABSTRACT FROM AUTHOR]

Abstract: Although recent forms of neoliberalism have been associated with everyday forms of ‘investment’, this paper argues that the financial conduct of everyday populations has long been an intense site of intervention. Drawing on the history of nineteenth and twentieth‐century Canadian government savings, annuities and tax deferral programs, this paper argues that everyday financial conduct has long been a key site of experimentation and innovation in practices of the self. These programs experiment with a language and practice of investment which emphasizes everyday conduct as a space of individual responsibility attached to diverse political goals. This suggests that enterprise as a mode of self and citizenship has a diverse and longer trajectory that predates neoliberalism. By extension, this paper conclude with a case for more diversified, complicated and historically‐situated analyses of ‘neoliberalism’. [ABSTRACT FROM AUTHOR]

Background: Resource allocation decisions for disease categories can be informed by proper estimates of the magnitude and distribution of total spending. In the backdrop of a high burden of Non-Communicable Diseases and Injuries (NCDI) in India, and a paucity of estimates on government spending on NCDI, this paper attempts to analyse public sector expenditure on NCDI spending in India. Methods: Various recent budget documents of the Centre and States/Union Territories have been used to extract expenditure on NCDI. The aggregates thus arrived at have been analysed to estimate aggregate and state level per capita spending. State level spending have been compared against disease burden using DALYs. Patterns of spending on NCDI across states were also analysed together with state level poverty to observe possible patterns. Findings: The total spending on NCDI by the government is low at less than 0.5% of GDP. NCDI spending is little more than one-fourth of total health spending of the country and most spending takes place at the state level (80%). The Ministry of Health and Family Welfare’s share in Central spending on NCDI is around 65%, and currently it spends 20% of its total health spending on NCDI. The gap between spending and DALYs is the most for the economically vulnerable states. Also, the states with high poverty levels also have low per capita expenditure on NCDI Interpretation: India does not depend on donor funding for health. It will have to step up domestic funding to address the increasing disease burden of NCDIs and to reduce the high out-of-pocket expenditure on NCDI. Policies on NCDI need to focus on UHC, service integration and personnel gaps. [ABSTRACT FROM AUTHOR]

In this paper, complex network theory is used to make time-series analysis of key indicators of governance structure and financing data. We analyze scientific listed companies’ governance data from 2010 to 2014 and divide them into groups in accordance with the similarity they share. Then we select sample companies to analyze their financing data and explore the influence of governance structure on financing decision and the financing preference they display. This paper reviews relevant laws and regulations of financing from the perspective of law and economics, then proposes reasonable suggestions to consummate the law for the purpose of regulating listed companies’ financing. The research provides a reference for making qualitative analysis on companies’ financing. [ABSTRACT FROM AUTHOR]

Exchange and interpersonal relationships are central to the functioning and sustainability of socio-economic activities, including innovation. Grassroots innovations (GI) are dynamic and relational phenomena that evolve with grassroots innovators’ beliefs, expectations and obligatory relationships for varied resources, and the actualization of their desire to make novel and beneficial products. In this paper, the dynamics of exchange and interpersonal relationships that underpin the GI phenomenon are explored through the lens of exchange theory and the consideration of the psychological contract. While exchange theory provides an explanation for the interdependent and dyadic socio-economic relations present in GI, the psychological contract provides a view on the perceptions and expectations that are embedded in exchange and innovation activities. These two theoretical lenses serve as a foundation for the research to engage with the subjective reality of the grassroots innovators’ experiences. In examining the subjective reality of the innovation experiences of the grassroots innovators; the research thereby discerns the dominant form of exchange and socio-economic structure that fosters GI from ideation to commercial scaling. Through the use of phenomenological exploration and detailed thematic analysis of the innovation experiences of the thirteen Indian grassroots innovators, the research determined the nature and spirit of the relational commercial exchanges that both entail and foster GI. The paper starts off with the discussion of the theoretical foundations of the research. Thereafter, the paper briefly discusses the research methodology and the exchange dynamics present in GI. In assimilating the research findings, the paper enlists the features of exchanges embedded in GI phenomenon and highlights the capacity of relational commercial exchanges in fostering GI. The paper further proposes, through this discussion, an interpretive framework for understanding how exchange influences the development of GI. Finally, the paper concludes with an identification of the dynamics of exchange within the GI process, and ascertains the necessary conditions for GI to flourish in commercial space. [ABSTRACT FROM AUTHOR]

The Global Financial Crisis of 2007-2008 wiped out US$37 trillions across global financial markets, this value is equivalent to the combined GDPs of the United States and the European Union in 2014. The defining moment of this crisis was the failure of Lehman Brothers, which precipitated the October 2008 crash and the Asian Correction (March 2009). Had the Federal Reserve seen these crashes coming, they might have bailed out Lehman Brothers, and prevented the crashes altogether. In this paper, we show that some of these market crashes (like the Asian Correction) can be predicted, if we assume that a large number of adaptive traders employing competing trading strategies. As the number of adherents for some strategies grow, others decline in the constantly changing strategy space. When a strategy group grows into a giant component, trader actions become increasingly correlated and this is reflected in the stock price. The fragmentation of this giant component will leads to a market crash. In this paper, we also derived the mean-field market crash forecast equation based on a model of fusions and fissions in the trading strategy space. By fitting the continuous returns of 20 stocks traded in Singapore Exchange to the market crash forecast equation, we obtain crash predictions ranging from end October 2008 to mid-February 2009, with early warning four to six months prior to the crashes. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the revenue to consultant physicians for private out-patient consultations. Specifically, the study determined changing patterns in revenue from 2011 to 2015 after accounting for bulk-billing rates, changes in gap fees and inflation. Methods: An analysis was performed of consultant physician Medicare claims data from 2011 to 2015 for initial (Item 110) and subsequent (Item 116) consultations and, for patients with multiple morbidities, initial management planning (Item 132) and review consultations (Item 133). The analysis included 12 medical specialties representative of common adult non-surgical medical care. Revenue to consultant physicians was calculated for initial consultations (Item 110: standard; Item 132: complex) and subsequent consultations (Item 116: standard; Item 133: complex) accounting for bulk-billing rates, changes in gap fees and inflation. Results: From 2011 to 2015, there was a decrease in inflation-adjusted revenue from standard initial and subsequent consultations (mean –$2.69 and –$1.03 respectively). Accounting for an increase in the use of item codes for complex consultations over the same time period, overall revenue from initial consultations increased (mean +$2.30) and overall revenue from subsequent consultations decreased slightly (mean –$0.28). All values reported are in Australian dollars. Conclusions: The effect of the multiyear Medicare freeze on consultant physician revenue has been partially offset by changes in billing practices. What is known about the topic?: There was a 'freeze' on Medicare schedule fees for consultations from November 2012 to July 2018. Concerns were expressed that the schedule has not kept pace with inflation and does not represent appropriate payments to physicians. What does this paper add?: Accounting for bulk-billing, changes in gap fees and inflation, revenue from standard initial and subsequent consultations decreased from 2011 to 2015. Use of item codes for complex consultations (which have associated higher schedule fees) increased from 2011 to 2015. When standard and complex consultation codes are analysed together (and accounting for bulk-billing, changes in gap fees and inflation), revenue from initial consultations increased and revenue from subsequent consultations decreased slightly. What are the implications for practitioners?: Efforts to control government expenditure through Medicare rebate payment freezes may result in unintended consequences. Although there were no overall decreases in bulk-billing rates, the shift to higher-rebate consultations was noticeable. [ABSTRACT FROM AUTHOR]

This paper studies the impact of managerial traits, i.e. optimism, confidence and risk aversion, on capital structure using a principle-agent framework. We discover that optimistic manager perceives equity as more undervalued than debt, while, confident manager perceives debt as more undervalued than equity. We also find that there exists the level of risk aversion eliminating the impact of optimism and confidence on the leverage. Furthermore, in contrast to rational manager, the optimistic/confident manger has higher level of effort. And then, the increasing in risk aversion reduces the level of effort. Our results are in line with some empirical findings. [ABSTRACT FROM AUTHOR]

The financial risk not only affects the development of the company itself, but also affects the economic development of the whole society; therefore, the financial risk assessment of company is an important part. At present, numerous methods of financial risk assessment have been researched by scholars. However, most of the extant methods neither integrated fuzzy sets with quantitative analysis, nor took into account the historical data of the past few years. To settle these defects, this paper proposes a novel financial risk assessment model for companies based on heterogeneous multiple-criteria decision-making (MCDM) and historical data. Subjective and objective indexes are comprehensively taken into consideration in the financial risk assessment index system of the model, which combines fuzzy theory with quantitative data analysis. Moreover, the assessment information obtained from historical financial information of company, credit rating agency and decision makers, including crisp numbers, triangular fuzzy numbers and neutrosophic numbers. Furthermore, the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method is used to determine the ranking order of companies according to their financial risk. Finally, an empirical study of financial risk assessment for companies is conducted, and the results of comparative analysis and sensitivity analysis suggest that the proposed model can effectively and reliably obtain the company with the lowest financial risk. [ABSTRACT FROM AUTHOR]

Objective: This study asks 'Is capital investment in Australian public hospitals effectively funding patient access to efficient hospital care?' Methods: The study drew information from semistructured interviews with senior health infrastructure officials, literature reviews and World Health Organization (WHO) reports. To identify which systems most effectively fund patient access to efficient hospitals, capital allocation systems for 17 Organisation for Economic Cooperation and Development (OECD) countries were assessed. Results: Australian government objectives (equitable access to clinically appropriate, efficient, sustainable, innovative, patient-based) for acute health services are not directly addressed within Australian capital allocation systems for hospitals. Instead, Australia retains a prioritised hospital investment system for institutionally based asset replacement and capital planning, aligned with budgetary and political priorities. Australian systems of capital allocation for public hospitals were found not to match health system objectives for allocative, productive and dynamic efficiency. Australia scored below average in funding patient access to efficient hospitals. The OECD countries most effectively funding patient access to efficient hospital care have transitioned to diagnosis-related group (DRG) aligned capital funding. Measures of effective capital allocation for hospitals, patient access and efficiency found mixed government–private–public partnerships performed poorly with inferior access to capital than DRG-aligned systems, with the worst performing systems based on private finance. Conclusion: Australian capital allocation systems for hospitals do not meet Australian government standards for the health system. Transition to a diagnosis-based system of capital allocation would align capital allocation with government standards and has been found to improve patient access to efficient hospital care. What is known about the topic?: Very little is known about the effectiveness of Australian capital allocation for public hospitals. In Australia, capital is rarely discussed in the context of efficiency, although poor built capital and inappropriate technologies are acknowledged as limitations to improving efficiency. Capital allocated for public hospitals by state and territory is no longer reported by Australian Institute of Health and Welfare due to problems with data reliability. International comparative reviews of capital funding for hospitals have not included Australia. Most comparative efficiency reviews for health avoid considering capital allocation. The national review of hospitals found capital allocation information makes it difficult to determine 'if we have it right' in terms of investment for health services. Problems with capital allocation systems for public hospitals have been identified within state-based reviews of health service delivery. The Productivity Commission was unable to identify the cost of capital used in treating patients in Australian public hospitals. Instead, building and equipment depreciation plus the user cost of capital (or the cost of using the money invested in the asset) are used to estimate the cost of capital required for patient care, despite concerns about accuracy and comparability. What does this paper add?: This is the first study to review capital allocation systems for Australian public hospitals, to evaluate those systems against the contemporary objectives of the health systems and to assess whether prevailing Australian allocation systems deliver funds to facilitate patient access to efficient hospital care. This is the first study to evaluate Australian hospital capital allocation and efficiency. It compares the objectives of the Australian public hospitals system (for universal access to patient-centred, efficient and effective health care) against a range of capital funding mechanisms used in comparable health systems. It is also the first comparative review of international capital funding systems to include Australia. What are the implications for practitioners?: Clinical quality and operational efficiency in hospitals require access for all patients to technologically appropriate hospitals. Funding for appropriate public hospital facilities, medical equipment and information and communications technology is not connected to activity-based funding in Australia. This study examines how capital can most effectively be allocated to provide patient access to efficient hospital care for Australian public hospitals. Capital investment for hospitals that is patient based, rather than institutionally focused, aligns with higher efficiency. [ABSTRACT FROM AUTHOR]

Background: A widespread assumption across health systems suggests that greater clinicians' involvement in governance and management roles would have wider benefits for the efficiency and effectiveness of healthcare organisations. However, despite growing interest around the topic, it is still poorly understood how managers with a clinical background might specifically affect healthcare performance outcomes. The purpose of this review is, therefore, to map out and critically appraise quantitatively-oriented studies investigating this phenomenon within the acute hospital sector.Methods: The review has focused on scientific papers published in English in international journals and conference proceedings. The articles have been extracted through a Boolean search strategy from ISI Web of Science citation and search source. No time constraints were imposed. A manual search by keywords and citation tracking was also conducted concentrating on highly ranked public sector governance and management journals. Nineteen papers were identified as a match for the research criteria and, subsequently, were classified on the basis of six items. Finally, a thematic mapping has been carried out leading to identify three main research sub-streams on the basis of the types of performance outcomes investigated.Results and Contribution: The analysis of the extant literature has revealed that research focusing on clinicians' involvement in leadership positions has explored its implications for the management of financial resources, the quality of care offered and the social performance of service providers. In general terms, the findings show a positive impact of clinical leadership on different types of outcome measures, with only a handful of studies highlighting a negative impact on financial and social performance. Therefore, this review lends support to the prevalent move across health systems towards increasing the presence of clinicians in leadership positions in healthcare organisations. Furthermore, we present an explanatory model summarising the reasons offered in the reviewed studies to justify the findings and provide suggestions for future research. [ABSTRACT FROM AUTHOR]

This paper investigates institutional change in the Polish public science system (PPSS) in the past twenty years. Employing macro-statistical data, the paper argues that this change process has unfolded stepwise and relatively late despite major political and economic transformations in post-socialist Poland. Using a historical-institutionalist perspective, the paper focuses on processes of institutional change, including layering, displacement, and dismantling. One major finding is that the speed and depth of the gradual transformation differs considerably between the three research performing sectors of the Polish public science system. As the Polish Academy of Sciences was reproduced institutionally, the former governmental units for applied R&D were partly dismantled and displaced by private sector R&D units. In contrast, the Higher Education sector underwent a strong expansion and, thus, layering of new research activities and fields. Since policy shifts within the PPSS occurred relatively late, the more than two decades following the collapse of communism are of special interest to scholars of incremental, yet cumulative, institutional change. [ABSTRACT FROM AUTHOR]

In the public transport industry, travellers’ perceived satisfaction is a key element in understanding their evaluation of, and loyalty to ridership. Despite its notable importance, studies of customer satisfaction are under-represented in the literature, and most previous studies are based on survey data collected from a single city only. This does not allow a comparison across different transport systems. To address this underrepresentation, this paper reports on a study of train passengers’ satisfaction with the fare paid for their most recent home-based train trip in five Australian capital cities: Sydney, Melbourne, Brisbane, Adelaide, and Perth. Two data sources are used: a nation-wide survey, and objective information on the train fare structure in each of the targeted cities. In particular, satisfaction with train fares is modelled as a function of socio-economic factors and train trip characteristics, using a random parameters ordered Logit model that accounts for unobserved heterogeneity in the population. Results indicate that gender, city of origin, transport mode from home to the train station, eligibility for either student or senior concession fare, one-way cost, and waiting time as well as five diverse interaction variables between city of origin and socio-economic factors are the key determinants of passenger satisfaction with train fares. In particular, this study reveals that female respondents tend to be less satisfied with their train fare than their male counterparts. Interestingly, respondents who take the bus to the train station tend to feel more satisfied with their fare compared with the rest of the respondents. In addition, notable heterogeneity is detected across respondents’ perceived satisfaction with train fare, specifically with regard to the one-way cost and the waiting time incurred. An intercity comparison reveals that a city’s train fare structure also affects a traveller’s perceived satisfaction with their train fare. The findings of this research are significant for both policy makers and transport operators, allowing them to understand traveller behaviours, and to subsequently formulate effective transit policies. [ABSTRACT FROM AUTHOR]

Recent research suggests that psychological needs can influence the political attitudes of ordinary citizens, often outside of their conscious awareness. In this paper, we investigate whether psychological needs also shape the spending priorities of political elites in the US. Most models of policymaking assume that political elites respond to information in relatively homogeneous ways. We suggest otherwise, and explore one source of difference in information processing, namely, threat sensitivity, which previous research links to increased support for conservative policy attitudes. Drawing on a sample of state-level policymakers, we measure their spending priorities using a survey and their level of threat sensitivity using a standard psychophysiological measure (skin conductance). We find that, like ordinary citizens, threat sensitivity leads even state-level policymakers to prioritize spending on government polices that are designed to minimize threats. [ABSTRACT FROM AUTHOR]

Strategic purchasing is an essential health financing function. This paper compares the strategic purchasing practices of Thailand’s two tax-financed health insurance schemes, the Universal Coverage Scheme (UCS) and the Civil Servant Medical Benefit Scheme (CSMBS), and identifies factors contributing to successful universal health coverage outcomes by analysing the relationships between the purchaser and government, providers and members. The study uses a cross-sectional mixed-methods design, including document review and interviews with 56 key informants. The Comptroller General Department (CGD) of Ministry of Finance manages CSMBS as one among civil servant welfare programmes. Their purchasing is passive. Fee for service payment for outpatient care has resulted in rapid cost escalation and overspending of their annual budget. In contrast, National Health Security Office (NHSO) manages purchasing for UCS, which undertakes a range of strategic purchasing actions, including applying closed ended provider payment, promoting primary healthcare’s gate keeping functions, exercising collective purchasing power and engaging views of members in decision making process. This difference in purchasing arrangements resulted in expenditure per CSMBS member being 4 times higher than UCS in 2014. The governance of the purchaser organization, the design of the purchasing arrangements including incentives and use of information, and the institutional capacities to implement purchasing functions are essential for effective strategic purchasing which can improve health system efficiency as a whole. [ABSTRACT FROM AUTHOR]

When standard optimization methods fail to find a satisfactory solution for a parameter fitting problem, a tempting recourse is to adjust parameters manually. While tedious, this approach can be surprisingly powerful in terms of achieving optimal or near-optimal solutions. This paper outlines an optimization algorithm, Adaptive Stochastic Descent (ASD), that has been designed to replicate the essential aspects of manual parameter fitting in an automated way. Specifically, ASD uses simple principles to form probabilistic assumptions about (a) which parameters have the greatest effect on the objective function, and (b) optimal step sizes for each parameter. We show that for a certain class of optimization problems (namely, those with a moderate to large number of scalar parameter dimensions, especially if some dimensions are more important than others), ASD is capable of minimizing the objective function with far fewer function evaluations than classic optimization methods, such as the Nelder-Mead nonlinear simplex, Levenberg-Marquardt gradient descent, simulated annealing, and genetic algorithms. As a case study, we show that ASD outperforms standard algorithms when used to determine how resources should be allocated in order to minimize new HIV infections in Swaziland. [ABSTRACT FROM AUTHOR]

Background: The WHO HIV Treatment Guidelines suggest routine viral-load monitoring can be used to differentiate antiretroviral therapy (ART) delivery and reduce the frequency of clinic visits for patients stable on ART. This recommendation was informed by economic analysis that showed the approach is very likely to be cost-effective, even in the most resource constrained of settings. The health benefits were shown to be modest but the costs of introducing and scaling up viral load monitoring can be offset by anticipated reductions in the costs of clinic visits, due to these being less frequent for many patients. Key issues for economic evaluation: The cost-effectiveness of introducing viral-load informed differentiated care depends upon whether cost reductions are possible if the number of clinic visits is reduced and/or how freed clinic capacity is used for alternative priorities. Where freed resources, either physical or financial, generate large health gains (e.g. if committed to patients failing ART or to other high value health care interventions), the benefits of differentiated care are expected to be high; if however these freed physical resources are already under-utilized or financial resources are used less efficiently and would not be put to as beneficial an alternative use, the policy may not be cost-effective. The implication is that the use of conventional unit costs to value resources may not well reflect the latter’s value in contributing to health improvement. Analyses intended to inform resource allocated decisions in a number of settings may therefore have to be interpreted with due consideration to local context. In this paper we present methods of how economic analyses can reflect the real value of health care resources rather than simply applying their unit costs. The analyses informing the WHO Guidelines are re-estimated by implementing scenarios using this framework, informing how differentiated care can be prioritized to generate greatest gains in population health. Implications: The findings have important implications for how economic analyses should be undertaken and reported in HIV and other disease areas. Results provide guidance on conditions under which viral load informed differentiated care will more likely prove to be cost effective when implemented. [ABSTRACT FROM AUTHOR]

This paper proposes an optimization model, using Mixed-Integer Linear Programming (MILP), to support decisions related to making investments in the design of power grids serving industrial clients that experience interruptions to their energy supply due to disruptive events. In this approach, by considering the probabilities of the occurrence of a set of such disruptive events, the model is used to minimize the overall expected cost by determining an optimal strategy involving pre- and post-event actions. The pre-event actions, which are considered during the design phase, evaluate the resilience capacity (absorption, adaptation and restoration) and are tailored to the context of industrial clients dependent on a power grid. Four cases are analysed to explore the results of different probabilities of the occurrence of disruptions. Moreover, two scenarios, in which the probability of occurrence is lowest but the consequences are most serious, are selected to illustrate the model’s applicability. The results indicate that investments in pre-event actions, if implemented, can enhance the resilience of power grids serving industrial clients because the impacts of disruptions either are experienced only for a short time period or are completely avoided. [ABSTRACT FROM AUTHOR]

Scientists are increasingly dissatisfied with funding systems that rely on peer assessment and, accordingly, have suggested several proposals for reform. One of these proposals is to distribute available funds equally among all qualified researchers, with no interference from peer review. Despite its numerous benefits, such egalitarian sharing faces the objection, among others, that it would lead to an unacceptable dilution of resources. The aim of the present paper is to assess this particular objection. We estimate (for the Netherlands, the U.S. and the U.K.) how much researchers would receive were they to get an equal share of the government budgets that are currently allocated through competitive peer assessment. For the Netherlands, we furthermore estimate what researchers would receive were we to differentiate between researchers working in low-cost, intermediate-cost and high-cost disciplines. Given these estimates, we then determine what researchers could afford in terms of PhD students, Postdocs, travel and equipment. According to our results, researchers could, on average, maintain current PhD student and Postdoc employment levels, and still have at their disposal a moderate (the U.K.) to considerable (the Netherlands, U.S.) budget for travel and equipment. This suggests that the worry that egalitarian sharing leads to unacceptable dilution of resources is unjustified. Indeed, our results strongly suggest that there is room for far more egalitarian distribution of funds than happens in the highly competitive funding schemes so prevalent today. [ABSTRACT FROM AUTHOR]

Background: In 2013, Kenya transitioned into a devolved system of government with a central government and 47 semi-autonomous county governments. In this paper, we report early experiences of devolution in the Kenyan health sector, with a focus on public county hospitals. Specifically, we examine changes in hospital autonomy as a result of devolution, and how these have affected hospital functioning. Methods: We used a qualitative case study approach to examine the level of autonomy that hospitals had over key management functions and how this had affected hospital functioning in three county hospitals in coastal Kenya. We collected data by in-depth interviews of county health managers and hospital managers in the case study hospitals (n = 21). We adopted the framework proposed by Chawla et al (1995) to examine the autonomy that hospitals had over five management domains (strategic management, finance, procurement, human resource, and administration), and how these influenced hospital functioning. Findings: Devolution had resulted in a substantial reduction in the autonomy of county hospitals over the five key functions examined. This resulted in weakened hospital management and leadership, reduced community participation in hospital affairs, compromised quality of services, reduced motivation among hospital staff, non-alignment of county and hospital priorities, staff insubordination, and compromised quality of care. Conclusion: Increasing the autonomy of county hospitals in Kenya will improve their functioning. County governments should develop legislation that give hospitals greater control over resources and key management functions. [ABSTRACT FROM AUTHOR]

Background: Policies such as the Cancer Drugs Fund in England assumed a societal preference to fund cancer care relative to other conditions, even if that resulted in lower health gain for the population overall.Objective: The aim of this study was to investigate the evidence for such a preference among the UK public.Methods: The MEDLINE, PubMed and Econlit electronic databases were searched for studies relating to preferences for prioritising cancer treatment, as well as studies relating to preferences for the characteristics of cancer (severity of disease, end-of-life). The searches were run in November 2015 and updated in March 2017. Empirical preference studies, studies of public views, and studies in English were included.Results: We identified 24 studies relating to cancer preferences. Two directly addressed health trade-offs in the UK-one showed a preference for health gain in cancer, while the other found no such preference but provided results consistent with population health maximisation. Other studies mostly showed support for cancer but did not require a direct health trade-off. Severity and end-of-life searches identified 12 and 6 papers, respectively, which were additional to existing reviews. There is consistent evidence that people give priority to severe illness, while results for end-of-life are mixed.Conclusion: We did not find consistent support for a preference for health gains to cancer patients in the context of health maximisation. The evidence base is small and the results are highly sensitive to study design. There remains a contradiction between these findings and the popular view of cancer, and further work is required to determine the features of cancer which contribute to that view. [ABSTRACT FROM AUTHOR]

The aim of the paper is to establish the future intervention priorities in building a new programme that would target the economic development in the research area. The used methodology included an adapted A'WOT analysis - an initial SWOT analysis and a prioritization of the items through an expert questionnaire. In the present paper we analyze the experts' opinions and the areas where intervention is needed for the optimum strategies for the 2014-2020 financial frame. These should rely on the strengths in the Guidelines for Applicants, the rules for projects implementation and the institutional system, it should consider changes on the weak points concerning the programme objectives, the Guidelines for Applicants and the beneficiaries consultations, it should make use of opportunities coming from the crossborder status, European Union frame and economic opportunities and overcome the differences coming from crossborder status, membership of two different supranational structures and the economic gaps. [ABSTRACT FROM AUTHOR]

Economic uncertainty and monetary uncertainty are said to affect public’s holding of money in either direction. In this paper, we consider the Korean demand for money, and after including two GARCH-based measures of output uncertainty and monetary uncertainty, we show that both measures exert significant effects on the demand for money in Korea in the short run. However, only the adverse effects of output uncertainty lasts into the long run. Indeed, including the two uncertainty measures yield a stable demand for money in Korea. [ABSTRACT FROM AUTHOR]

This paper has tested whether bank-based financial development and market-based financial development are complements of, or substitutes for, one another in enhancing economic growth in the usa, Brazil and Kenya during the period from1980 to 2012. These three countries represent amodest cross-section of the general financial structure prevalent in many developed and developing countries. Unlike some of the previous studies, the study employs the newly developed ardl-Bounds-testing approach to carry out the test. The study also employs the method of means-removed average to construct both bank-based and market-based financial development indices. The results of this study show that while in the usa and Brazil, bank-based and market-based financial systems complement each other in enhancing economic growth; in Kenya, the two financial systems seem to be substitutes rather than complements. [ABSTRACT FROM AUTHOR]

It is well known that a network structure plays an important role in addressing a collective behavior. In this paper we study a network of firms and corporations for addressing metastable features in an Ising based model. In our model we observe that if in a recession the government imposes a demand shock to stimulate the network, metastable features shape its response. Actually we find that there exists a minimum bound where any demand shock with a size below it is unable to trigger the market out of recession. We then investigate the impact of network characteristics on this minimum bound. We surprisingly observe that in a Watts-Strogatz network, although the minimum bound depends on the average of the degrees, when translated into the language of economics, such a bound is independent of the average degrees. This bound is about 0.44ΔGDP, where ΔGDP is the gap of GDP between recession and expansion. We examine our suggestions for the cases of the United States and the European Union in the recent recession, and compare them with the imposed stimulations. While the stimulation in the US has been above our threshold, in the EU it has been far below our threshold. Beside providing a minimum bound for a successful stimulation, our study on the metastable features suggests that in the time of crisis there is a “golden time passage” in which the minimum bound for successful stimulation can be much lower. Hence, our study strongly suggests stimulations to arise within this time passage. [ABSTRACT FROM AUTHOR]

This paper discusses the fundamentals of airport economics, governing the business in general. Based on representative ACI data, the structure of airport finances and resulting profitability will be exemplified from a global and regional perspective. The major characteristics will be identified from this, impacting on revenue and cost levels, capital productivity and structure, as well as capital spending. Due to their relationship with airline customers as well as travellers, airports are two-sided businesses. Moreover, infrastructure costs do not vary in direct proportion to traffic throughput. This makes airports fixed cost businesses in nature, continuously searching for new airlines, passengers and cargo in order to achieve economies of scale and increase commercial revenue at the same time. In combination with the investment cycle, this poses unique challenges for financial management in the sector beyond the typical activities of working capital management and investment funding. Airports and airlines are intrinsically linked and rely on one another to operate efficiently. Nevertheless, they are based on considerably different business models. While airlines are able to flexibly respond to changes in traffic flows by adjusting capacity, airports have to commit to long-term planning decisions to safeguard capacity many years ahead. Operating efficiency, capital productivity and cost of capital as well as an appropriate capital structure are essential for financial success. [ABSTRACT FROM AUTHOR]

The 'check effect' refers to the use of disability payments to purchase illegal drugs or alcohol. This paper describes subsequent research concerning three interrelated issues: the check effect, whether receipt of disability payments is associated with more overall substance use, and potential policy responses to misuse of disability payments for substances. Review and synthesis of published papers. Increased substance use at the beginning of the month has been described in a variety of settings. The tendency to purchase substances at the beginning of the month is impacted by household wealth, the tendency to discount future rewards and cyclical economic activity. However, in naturalistic observational cohort studies, beneficiaries who receive disability payments had no greater substance use than those without disability payments. Potential policy responses to mis-spending of disability checks include financial counseling that discourages spending on drugs and the assignment of a representative payee to prevent misuse of benefits for substances. Assignment of a representative payee per se has not been associated with reduced substance use, but payeeship administered by agencies that integrate payee practice into treatment has been. Disability payments impact the timing of substance use, but receipt of disability payments is not associated with more overall substance use than unalleviated poverty. Money management-based clinical interventions, which may involve assignment of a representative payee, can minimize the purchase of substances with disability payments. [ABSTRACT FROM AUTHOR]

Abstract: This paper aims to explore the operating efficiency and the benchmark-learning roadmap of military financial units for the finance center under the supervision of the Comptroller Bureau. A benchmarking managerial framework is developed and illustrated through application to the finance center. The framework encompasses a performance pyramid which embodies multiple perspectives of the organization under a balanced scorecard, data envelopment analysis, and cluster analysis. This assessment can assist the Comptroller Bureau to enhance the operational management of the finance center and to help military financial units deliver more efficient services, including the Armed Forces’ financial management, the audit of personnel-related expenditure, and the supervision and evaluation of the operation and financial management process. This paper highlights the potential applications and strengths of the methods used in assessing the military financial units. [Copyright &y& Elsevier]

Purpose - This paper aims to determine the effects of agricultural, recreational and urban variables on Oklahoma land prices. Design/methodology/approach - An econometric model is estimated using price of agricultural land parcels as the dependent variable and independent variables representing agricultural, recreational and urban uses. Recreational variables include county-level recreational income from Agricultural Census data as well as deer harvest for each county. Urban variables are functions of population and income for each county. The agricultural variables include rainfall as well as crop returns for cropland and cattle prices for pasture. Findings - Agricultural variables are the most important, followed by urban and then recreational variables. Transaction prices are higher than commonly used land-value survey data. The major recreational variable is deer harvest, which is more important in small tracts. The value of pasture is now greater than cropland. Small tract sizes receive substantial premiums. Research limitations/implications - Agriculture is still an important part of the Oklahoma economy, so the findings might differ in more densely populated states. As with most econometric models, there are possible biases due to errors in measurement or missing explanatory variables. Practical implications - The paper provides information that could be used by those wanting to estimate land value or wanting to manage land to increase its value. Originality/value - The paper differs from previous work in both variables considered and the data used. Also, most previous work has not as directly addressed the issue of the relative importance of agricultural, recreational and urban variables. [ABSTRACT FROM AUTHOR]

There is a growing concern that long-term care (LTC) needs of older adults lead to negative financial consequences for their family members. This paper examines whether the onset of dementia in parents influences wealth change among unmarried adult children regardless of their status as informal caregivers. Longitudinal data from seven waves (1998–2010) of the Health and Retirement Study (1540 person-wave observations) are used to analyze this question. Unconditional quantile regressions demonstrate that as a result of parental dementia diagnosis, unmarried adult children have lower wealth accumulation above the median of the wealth change distribution. These effects are more pronounced for unmarried adult children without siblings. Further, this response is observed to persist in the subsequent period as well. Both losses in labor income and nursing home expenditures may play a role in leading to wealth declines. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence that mobile phone health interventions (“mHealth”) can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH), a national text-message (SMS) based health communication service in Tanzania. Methods: We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320) and at any possible break-even volume. Results: In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively) from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS) was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs. Conclusions: These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners. While this strategy was sustainable for the implementer, a central concern is that health information may not reach those who are too poor to pay, limiting the program’s reach and impact. Incorporating strategies presented here may make mHealth programs more appealing to funders and investors but need further consideration to balance sustainability, scale, and impact. [ABSTRACT FROM AUTHOR]

If emerging markets are to achieve their objective of joining the ranks of industrialized, developed countries, they must use their economic and political influence to support radical change in the international financial system. This working paper recommends John Maynard Keynes's "clearing union" as a blueprint for reform of the international financial architecture that could address emerging market grievances more effectively than current approaches. Keynes's proposal for the postwar international system sought to remedy some of the same problems currently facing emerging market economies. It was based on the idea that financial stability was predicated on a balance between imports and exports over time, with any divergence from balance providing automatic financing of the debit countries by the creditor countries via a global clearinghouse or settlement system for trade and payments on current account. This eliminated national currency payments for imports and exports; countries received credits or debits in a notional unit of account fixed to national currency. Since the unit of account could not be traded, bought, or sold, it would not be an international reserve currency. The credits with the clearinghouse could only be used to offset debits by buying imports, and if not used for this purpose they would eventually be extinguished; hence the burden of adjustment would be shared equally — credit generated by surpluses would have to be used to buy imports from the countries with debit balances. Emerging market economies could improve upon current schemes for regionally governed financial institutions by using this proposal as a template for the creation of regional clearing unions using a notional unit of account. [ABSTRACT FROM AUTHOR]

Policy-makers desire an optimal balance of financial incentives to improve productivity and encourage improved quality in primary care, while also avoiding issues of risk-selection inherent to capitation-based payment. In this paper we analyze risk-selection in capitation-based payment by using administrative data for patients ( n = 11,600,911) who were rostered (i.e., signed an enrollment form, or received a majority of care) with a primary care physician ( n = 8621) in Ontario, Canada in 2010/11. We analyze this data using a relative distribution approach and compare distributions of patient costs and morbidity across primary care payment models. Our results suggest a relationship between being in a capitation-based payment scheme and having low cost patients (and presumably healthy patients) compared to fee-for-service physicians. However, we do not have evidence that physicians in capitation-based models are reducing the care they provide to sick and high cost patients. These findings suggest there is a relationship between payment type and risk-selection, particularly for low-cost and healthy patients. [ABSTRACT FROM AUTHOR]

The context-aware service system (CASS) for smart home services has received considerable attention due to advances made in context-awareness technologies. In recent years, various context-aware consumer electronics for intelligent and personalized user-centric services have been introduced. However, the conventional CASS has architectural limitations, including low availability, low interoperability, and low scalability. For example, it is difficult to modify or update the context-aware service (CAS) infrastructure once it has been built. Therefore, this paper proposes a zone-aware service system (ZASS) for cost-effective pervasive infrastructure. The main component of the ZASS is a zone-aware service agent (ZASA) which utilizes the user?s nomadic resource as a sensor or gateway. The term ?user?s nomadic resource? refers to the user?s hand-held device, which has a sensing or networking capability, such as a smartphone, smart watch, and mobile sensor, etc. As the utilization of the user?s nomadic resource, the ZASS can be cost-effectively implemented compared with the conventional CASS. The performance of the proposed system is discussed via a simple smart home service scenario. The experimental result showed that the proposed system can reduce the power consumption of an air conditioner by 20.7%. [ABSTRACT FROM AUTHOR]

Many manufacturing companies are facing uncertainties and stiff competition both locally and globally, intensified by increasing needs for sophisticated and high value products from demanding customers. These companies are forced to improve the quality of their supply chain management decisions, products and reduce their manufacturing costs. With today's volatile and very challenging global market, many manufacturing companies have started to realize the importance of the proper managing of their supply chains. Supply chain management (SCM) involves practices such as strategic supplier partnership, customer focus, lean production, postpone concept and technology & innovation. This study investigates the importance of SCM on financial optimization. The study measures production or SCM managers' perceptions regarding SCM and level of performances in their companies. The paper also specifically investigates whether supply chain performance acts as a mediating variable in the relationship between SCM and financial optimization. These associations were analyzed through statistical methods such as Pearson's correlation and a regression-based mediated analysis. The findings suggest that SCM has significant correlations with supply chain performance and financial optimization. In addition, the result of the regression-based mediated analysis demonstrates that supply chain performance mediates the linkage between SCM and financial optimization. The findings of the study provide a striking demonstration of the importance of SCM in enhancing the performances of Malaysian manufacturing companies. The result indicates that manufacturing companies should emphasize greater management support for SCM implementation and a greater degree of attention for production integration and information flow integration in the manufacturing system in order to maximize profit and minimize cost. [ABSTRACT FROM AUTHOR]

Valorization of knowledge generated by the fast advance of science and its marketing has led to the so-called "knowledge-based economy" and as a consequence high-technology (HiTech) companies have emerged. Those based in Biotechnology have some specific features compared to other HiTech sectors. This paper provides a model to structure the economic management of HiTech Biotechnology organizations in Cuba, considering the national economy and the experience accumulated by several institutions from the Scientific Biotech Pole in Western Havana. The model is based on some concepts and proposals, and it addresses key elements, such as: insurance of adequate funding levels for R&D activities and technology replacement, fl exible import and export management, the ability to get into very competitive markets and preservation of a highly qualified workforce. It also demonstrates the feasibility to establish this kind of enterprises in the context and regulations already existing in a non-capitalist environment, in the middle of the update of Cuban economy. [ABSTRACT FROM AUTHOR]

Returns and probability distribution of log-returns in the financial time series are crucial for further development of quantitative finance. This paper suggests more appropriate distribution for the gold future index by reviewing history of the asset return distributions and documenting some stylized facts. The return of the sample of daily 2364 observations is fitted to different distribution. This identifies the Student's t distribution with about 4.4 degree of freedom as a typical estimated logreturn distribution for Gold future index with significance level of 1%. Test of the goodness of fit and log-likelihood values are performed in order to quantitatively access the quality of the estimation. Furthermore, this result can be interpreted as a stylized fact with a high level of significance. [ABSTRACT FROM AUTHOR]

Abstract: There is a well-established literature analyzing the effects of fiscal institutions on fiscal policy variables such as budget deficits or accumulated government debt. We combine this literature with the emerging field of positive constitutional economics, which deals with the economic effects of constitutional rules. The paper addresses three questions: (1) Do budget provisions that are explicitly spelled out in a country''s constitution have any significant effect on fiscal policy? (2) Does the transparency, or lack thereof, of the budget process have any significant effect on fiscal policy? and (3) Do these two variables have an impact on other variables such as government effectiveness and productivity? We find that constitutionally entrenched spending limits are correlated with lower total government expenditure and that the transparency of a nation''s budget is correlated with higher government effectiveness as well as lower corruption. If anything, the deficit limits entrenched in the Maastricht Treaty are correlated with higher, rather than lower, overall government expenditure. [Copyright &y& Elsevier]

Many governments in Europe, either of their own volition or at the behest of the international financial institutions, have adopted stringent austerity policies in response to the financial crisis. By contrast, the USA launched a financial stimulus. The results of these experiments are now clear: the American economy is growing and those European countries adopting austerity, including the UK, Ireland, Greece, Portugal and Spain, are stagnating and struggling to repay rising debts. An initial recovery in the UK was halted once austerity measures hit. However, austerity has been not only an economic failure, but also a health failure, with increasing numbers of suicides and, where cuts in health budgets are being imposed, increasing numbers of people being unable to access care. Yet their stories remain largely untold. Here, we argue that there is an alternative to austerity, but that ideology is triumphing over evidence. Our paper was written to contribute to discussions among health policy leaders in Europe that will take place at the 15th European Health Forum at Gastein in October 2012, as its theme 'Crisis and Opportunity -- Health in an Age of Austerity'. [ABSTRACT FROM AUTHOR]

Background: While there is accumulated evidence showing the rapid rise of the burden caused by non-communicable diseases (NCDs) in Vietnam, information on the extent to which households in the country suffer financial catastrophe or impoverishment caused by the diseases is still largely lacking. This paper aims to examine the self-reported prevalence of major chronic diseases among a population in rural Vietnam and to analyse the household financial burden associated with these diseases. Methods: A cross-sectional survey of 800 randomly selected households was carried out in Vo Nhai District, Thai Nguyen Province, in 2010. Face-to-face interviews were conducted with key informants of selected households on diagnosed chronic NCDs, health care utilization and health expenditure of all household members. The World Health Organization's definitions of catastrophic expenditure and impoverishment were used. Both descriptive and analytical statistics were applied. Results: The prevalence of chronic NCDs in households and individuals was 29.3 and 33.4%, respectively. The catastrophic health expenditure and impoverishment rates among the households who have at least one member with a chronic disease were 14.6 and 7.6%, respectively. These rates were significantly higher than the corresponding figures among the households whose members were free from the diseases (4.2 and 2.3%, respectively). The odds of experiencing catastrophic health expenditure and impoverishment among the household with NCD patients were 3.2 and 2.3 times greater than that of other households. Conclusion: Findings from this study indicate that the epidemiological and household financial burdens caused by chronic diseases in Vietnam are now substantial and need immediate mitigation measures. [ABSTRACT FROM AUTHOR]

The contemporary rise of China in the new geo-economy is increasingly pressurising the spatial distribution of financial activity in mainland China and Hong Kong. With the reemergence of Shanghai, many people foresee the future demise of Hong Kong as the most important financial centre for the Chinese mainland. This paper shows that this conviction seems rather premature. From an examination of the regional distribution pattern of the mainland-China-based companies listed on the stock exchanges of Shanghai and Hong Kong it appears that both financial centres have relatively distinct hinterlands. Furthermore, it is shown that the exchanges of Shanghai and Hong Kong differ strongly in terms of sectoral specialisation. These results indicate that both centres reveal a considerable amount of complementarity. [ABSTRACT FROM AUTHOR]

Abstract: How to effectively predict financial distress is an important problem in corporate financial management. Though much attention has been paid to financial distress prediction methods based on single classifier, its limitation of uncertainty and benefit of multiple classifier combination for financial distress prediction has also been neglected. This paper puts forward a financial distress prediction method based on weighted majority voting combination of multiple classifiers. The framework of multiple classifier combination system, model of weighted majority voting combination, basic classifiers’ voting weight model and basic classifiers’ selection principles are discussed in detail. Empirical experiment with Chinese listed companies’ real world data indicates that this method can greatly improve the average prediction accuracy and stability, and it is more suitable for financial distress prediction than single classifiers. [Copyright &y& Elsevier]

One of the European Union's explicitly formulated goals is reducing the lags in development and narrowing the gaps in income between its member states and regions. In order to attain these goals, the Union's regional policy employs a system of vertical conditional grants known as the Structural Funds. Various attempts have been made to evaluate the effectiveness of this policy in promoting convergence. This paper adds to the existing literature in focusing the investigation on the role of the member states' federal structure. A short discussion drawing mainly on the theory of fiscal federalism provides the basis for an empirical model. Using a sample of 13 European countries in the period from 1975–1995 we estimate the effect varying decentralization among the member states has on the conditional effectiveness of Structural Funds expenditure. The results suggest that Structural Funds are more effective in promoting growth when the states exhibit a higher degree of decentralization. [ABSTRACT FROM AUTHOR]