Management of vaccinations in Italy: a national survey after healthcare regionalization

Abstract

Objectives:

The main aim of this study was to describe the effects of regional organization and performance in managing vaccinations, in the light of the institutional devolution recently introduced in Italy.

Methods:

We analysed (1) the general organization of regions for vaccination programmes, (2) the management of four vaccination programmes (combined measles-rubella-parotitis, varicella for children, influenza, and pneumococcal 23-valent for adults).

First, we conducted preliminary face-to-face interviews with 16 regional managers of the infective disease prevention departments. Subsequently, we sent them a standardized questionnaire to obtain comparable information on general organization and on the four specific vaccination programmes considered. In all, 14 regions were eventually included.

Results:

The survey showed a widespread lack of regional staff involved in the management of vaccinations and a geographical variation in the availability of computerized data collection. We recorded poor coverage for varicella and pneumococcal 23-valent vaccinations compared to MRP and influenza. Prices of the four vaccines varied widely among regions, with only a weak correlation between prices and volumes.

Limitations and conclusions:

The major limitation of the survey was the lack of information available at regional level. The piecemeal diffusion of computerized systems and the widespread lack of sufficient staff should mainly explain this.

Economic incentives could be offered to regions that achieve national targets. Such incentives should encourage collaboration between central and regional authorities consistent with institutional trends in regional devolution.     

A national energy-conservation policy Delphi: report of the findings

In formulating a National Energy Conservation Policy, it is essential to be aware of all available options as well as the opinions of experts. The Policy Delphi approach is used hereto identify policy issues involved in conserving energy in the national context. The three objectives of this study were 1) to identify and select critical, operational, and future-oriented policy statements concerning energy conservation, 2) to obtain the consensus of experts in the field, and 3) to estimate the potential utility of the technique in studying energy conservation policy planning. The study was conducted in three rounds. The results favored the formulation and implementation of a national policy on energy conservation. This study is expected to be of use to policy-planning agencies like the Planning Commission, Ministry of Energy, Department of Science and Technology, etc.     

Inequality of income derived from survey data during the inflationary period

By using the Lorenz curve technique this note demonstrates that the inequality of income derived from survey data during the inflationary period is overestimated.     

Wage-related labour standards and FDI in China: some survey findings from Guangdong province

Abstract. The paper presents findings from a survey of foreign invested enterprises (FIEs) in Guangdong, China, on the relationship between foreign direct investment (FDI) and wage‐related labour standards (regular wages, and compliance with official overtime and minimum wages), which show that wage‐related standards are statistically higher in FIEs whose home countries’ standards are higher, after controlling for other influences. However, a cost‐reduction FIE is more likely to be associated with inferior standards. The results call for a finer examination of the relationship between FDI and labour standards beyond the simple ‘race to the bottom’ thesis.     

Using paradata to collect better survey data: Evidence from a household survey in Tanzania

Data are a key component in the design, implementation, and evaluation of economic and social policies. Monitoring data quality is an essential part of any serious, large‐scale data collection process. The purpose of this article is to show how paradata should be used before, during, and after data collection to monitor and improve data quality. To do this we use timestamps, global positioning system (GPS) coordinates, and other paradata collected from an 800‐household survey conducted in Tanzania in 2016. We demonstrate how key paradata can be used during each phase of a research project to identify and prevent issues in the data and the methods used to collect it. Our results corroborate the importance of collecting and analyzing paradata to monitor fieldwork and ensuring data quality for micro data collection in developing countries. Based on these findings we also make recommendations as to how researchers can make better use of paradata in the future to manage and improve data quality. We argue for an expansion in the understanding and use of varied paradata among researchers, and a greater focus on its use for improving data quality.     

"Quicker and sicker" under Medicare's prospective payment system for hospitals: new evidence on an old issue from a national longitudinal survey

Medicare's prospective payment system for hospitals (PPS), introduced in the USA in 1983, replaced cost reimbursement with a system of fixed rates which created incentives for hospitals to control costs. Previous studies found that elderly patients were discharged from hospital "quicker and sicker" under PPS and concluded that families were coping at home. We analyse a national longitudinal survey, the first National Health and Nutrition Examination Survey and its Epidemiologic Followup Study, which includes data on more outcomes over a longer period than earlier studies. We find that the rate of admission to nursing homes from the community in the first weeks after a hospital discharge more than tripled under PPS, suggesting that families were not always able to cope. As another response to sicker patients, discharges directly to nursing homes from hospitals, which jumped initially under PPS, may have risen further when payment rates were tightened in the early 1990s. Hospital readmissions fell after the first few years. Our findings are strengthened by the fact that we control for patients' health using health information collected independently of hospital admission.     

Stuck in the Middle: Off-Farm Employment and Caregiving Among Middle-Aged Rural Chinese

ABSTRACT

Using the China Health and Retirement Longitudinal Study (CHARLS) 2011–12 baseline data, this contribution explores to what extent taking care of grandchildren and frail parents influences rural middle-aged Chinese adults’ off-farm employment. The findings show that, conditional on socioeconomic and demographic characteristics, taking care of grandchildren has a negative effect on rural middle-aged men's and women's off-farm job participation and hours worked. Caregiving for parents does not have the same negative effects on off-farm employment and hours worked. Furthermore, the study finds that annual earnings are also negatively affected by caregiving responsibilities, especially for women and men taking care of grandchildren.     

Race, ethnicity, and insurance as determinants of epidural use: analysis of a national sample survey

Despite widespread availability of pain interventions in childbirth, for most women, childbirth is associated with labor pain that exceeds expectations. Although epidural is superior to other medical interventions, the choice to use epidural still remains a matter of patient and doctor preference. Whether racial or ethnic characteristics influence preference of physician use or interact with insurance coverage is still unknown. This study used a large national sample of women to measure significant determinants of epidural use in order to discuss disparities in pain management. The findings suggest the need for nurse leaders to foster health policies that are sensitive to diversity and economics.     

The effects of financial education in the workplace: evidence from a survey of households

We use a novel household survey to investigate the effects of employer-based financial education on personal saving. We explore cross-sectional relations between the availability of employer-based financial education and various measures of asset accumulation, and we interpret these patterns in light of various potentially confounding factors. Our findings favor the hypothesis that employer-based financial education stimulates saving, both in general and for retirement.     

Taxation and consumption: evidence from a representative survey of the German population

Using a representative survey of the German population, this article studies self-reported individual consumption responses to a recent exogenous payroll tax reduction. About 55% of the respondents report that they spend the extra money, indicating considerable potential for tax changes to affect consumption and economic activity. Our analysis of the socio-demographic and economic covariates of consumption responses suggests, among other effects, that interest rates are related to consumption responses to tax changes, and that households with higher income have a higher propensity to consume.     

Taxation and labour supply: Evidence from a representative population survey

We study how taxation influences labour supply using a specifically designed representative survey of the German population. First, we investigate whether taxes generally matter for the labour supply decisions of our respondents. Around 41 per cent report taking taxes into consideration, implying that the majority of the German population is unresponsive to taxation. Second, we look at self-reported labour supply adjustments following a recently enacted payroll tax change. Only around 12 per cent of our respondents report an actual labour supply response, but we find evidence of an income, as well as a substitution, effect of the tax change. Our conclusion is that the effects of taxes on labour supply in Germany are likely small. We analyse the correlation with economic and socio-demographic variables and find that the self-employed are relatively more sensitive to taxation and that low interest rates reduce incentives for expanding the labour supply.     

Convertible bonds issued in the bear market period: evidence from Taiwan

We argue that the behaviour of enterprises might be modified or even changed completely after black swan events occur. We explore why high-tech firms preferred to issue convertible bonds in 2001–2003, the bear market period after the tech bubble in Taiwan. We show that firms issuing convertible bonds are those with low directors’ holding ratio and high debt ratio. Results also reveal that corporate governance was worse in the firms that issued convertible bonds, as revealed by the finding that the directors’ holding ratio of these issuing firms declined considerably. This finding also implies that corporate governance issues become more serious after black swan events.     

Public investment programmes in the interwar period: the view from Geneva *

Abstract

Social Catholicism opposed individualistic conceptions of society in favour of an order of associative institutions fostering a communality of interests between those involved in production processes. As a consequence, guilds were idealised and their model transposed in different ways to the industrial society of the nineteenth century. This paper discusses the different streams of Social Catholicism and the theoretical roots of corporatism in natural law. It will discuss how the idea of a ‘corporative order’ is more grounded in German corporative law than in Neo-Thomism.     

Absenteeism in the workplace: results from Danish sample survey data

Absentee data is analyzed using a worker environmental survey carried out in 1995. In a model which distinguishes between discretionary and involuntary absences individuals are assumed to maximize expected utility. This generates a probability distribution of days absent per year which is a mixture of two negative binomial distributions representing the behaviour of two unknown types of agent. This distribution is estimated separately for men and women. For each gender the number of days absent is quite small relative to what researchers have found in other countries. In the empirical model we identify different effects of the explanatory variables for workers with low rates of absenteeism and workers with high rates of absenteeism.     

Living arrangements of the elderly in China: evidence from the CHARLS national baseline

Declining fertility in China has raised concerns about elderly support, especially when public support is inadequate. Using rich information from the nationally representative China Health and Retirement Longitudinal Study (CHARLS) baseline survey, we describe the patterns of current living arrangements of the Chinese elderly and investigate their determinants and correlation with intergenerational transfers. We find that roughly 41% of Chinese aged 60 and over live with an adult child; living with a male adult child being strongly preferred. However another 34% have an adult child living in the same immediate neighborhood and 14% in the same county; only 5% have an adult child with none of them living in the same county. At the same time, a large fraction of the elderly, 45% in our sample, live alone or with only a spouse. In general, women, those from western provinces, and those from rural areas are more likely to live with or close to their adult children than their corresponding counterparts, but different types of intergenerational transfers play a supplementary role in the unequal distribution of living arrangements. Among non-co-resident children, those living close by visit their parents more frequently and have more communications by other means. In contrast, children who live farther away are more likely to send financial and in-kind transfers and send larger amounts.     

Firm age: a survey

This survey paper synthesizes theory and evidence on processes of firm-level aging. We discuss why anthropomorphic analogies are not helpful for understanding firm aging, because of differences in population pyramid shapes (with around 50 % of firms exiting after just 3 years), no upper bound on firm ages, and no deterministic change in performance with firm age. We discuss the liabilities of newness, adolescence, and senescence and obsolescence, and define what we mean by the direct and indirect causal effects of age. Our causal model also helps clarify previous confusion about why controlling for size in regressions of firm age on survival can reverse the results (Simpson’s paradox and the ‘bad control’ problem). While aging processes can occur at many levels (employee-level, firm-level, cohort-level, etc.), we focus on the firm-level. We summarize empirical work on firm age and conclude that the most interesting age effects occur within the first 5–7 years, which underscores the importance of datasets that do not under-represent young firms.     

并行化模糊测试研究综述

随着新一代网络信息技术的不断创新突破,软件从单机场景逐步扩展到移动终端、物联网设备、工业控制设备、云计算平台等新兴领域,推动了信息化基础设施建设的发展。然而,应用软件质量良莠不齐,给黑客组织提供了可乘之机。事件型漏洞和高危零日漏洞数量上升,如何高效准确地挖掘软件漏洞亟待解决。为实现漏洞的快速检测,模糊测试技术备受关注,它具有部署简单、自动化程度高、兼容性好等特点,能通过提供大量的输入样例实现对目标程序的脆弱性分析。现有的模糊测试通常在单处理器环境中执行,存在单个检测任务耗时长、计算资源利用率低、可持续能力差等缺陷。因此,并行化模糊测试一经提出便备受青睐。针对并行架构下的任务划分、数据存储、通信交互等问题,学术界和工业界对其展开了深入分析,并设计了一系列的实现方法。为此,系统地总结了当前模糊测试面临的挑战,概述了当前阶段模糊测试的并行化需求,着重比较分析了现存并行化模糊测试方案的优势和不足,并对高性能计算场景下并行化模糊测试的未来趋势进行了展望。