Clinical characteristics,treatment patterns,and socio-economic burden of COPD in Bulgaria

Background: While the impact of COPD in Western-Europe is known, data from Eastern-Europe is scarce. This study aimed to evaluate clinical characteristics, treatment patterns, and the socio-economic burden of COPD in Eastern-Europe, taking Bulgaria as a reference case.

Methods: A representative sample of Bulgarian patients with COPD was randomly chosen by pulmonologists, based on the following inclusion criteria: COPD diagnosis with at least 1 year of living with COPD, ≥40 years of age, and use of COPD medication. Patient characteristics, treatment, quality-of-life, healthcare resource use, and costs were systematically assessed.

Results: A total of 426 COPD patients were enrolled. Approximately 69% were male, 40% had occupational risk factors, 45% had severe and 11% had very severe COPD. Mean CAT scores were 13.80 (GOLD A), 21.80 (GOLD B), 17.35 (GOLD C), and 26.70 (GOLD D). Annual per-patient costs of healthcare utilization were €579. Yearly pharmacotherapy costs were €693. Indirect costs (reduced and lost work productivity) outnumbered direct costs three times.

Conclusions: Bulgaria has relatively high percentages of (very) severe COPD patients, resulting in considerable socio-economic burden. High smoking rates, occupational risk factors, air pollution, and a differential health system may be related to this finding. Eastern-European COPD strategies should focus on prevention, risk-factor awareness, and early detection.     

Triple play: How do we secure future benefits?

Recent technological developments make it possible to provide all telecommunications services (TV, telephony and internet) via the TV cable and fixed telephony network. Moreover, a new infrastructure based on optical fibre (to the home) is emerging in some places, which may in the future replace both existing networks. Making use of the available economic literature, the paper analyzes some of the consequences of the emergence of one electronic communications market. It focuses on two policy issues: the consequences of convergence of technologies and competition between networks for regulation in the short and medium runs, and the role of public investment in the rollout of optical fibre. It concludes that the present state of regulation may have some undesirable effects in the face of convergence and that public investment in a new general purpose infrastructure may have important advantages.     

Effects of Unit-Based Garbage Pricing: A Differences-in-Differences Approach

Using a unique 10-year dataset of all 458 Dutch municipalities, we apply a differences-in-differences approach to estimate the effect of unit-based pricing on household waste quantities and recycling. Community-level studies of unit-based pricing typically do not include fixed effects at the local level. We find that failure to do so may substantially inflate the estimated price effect. We also find that unit-based pricing may be endogenous, and use instrumental variables to account for this. Our analysis shows that user fees depend on user fees in neighboring jurisdictions (policy interaction). Our estimate of the garbage reduction per $1 user fee is lower than any previous estimate bar one. The price effect depends on the pricing system: weight-based systems reduce garbage quantities more than volume-based systems. User fees increase recycling, especially of paper, but not nearly as much as they reduce garbage quantities. We find no evidence for waste tourism or illegal dumping.     

Bayesian estimation of explained variance in ANOVA designs

We propose to use the squared multiple correlation coefficient as an effect size measure for experimental analysis‐of‐variance designs and to use Bayesian methods to estimate its posterior distribution. We provide the expressions for the squared multiple, semipartial, and partial correlation coefficients corresponding to four commonly used analysis‐of‐variance designs and illustrate our contribution with two worked examples.     

Legal But Costly: An Analysis of the EU GM Regulation in the Light of the WTO Trade Dispute Between the EU and the USA

In this study, we investigate the new European Union (EU) regulations in the light of the ruling by the World Trade Organization (WTO) panel on the trade in genetically modified crops. To this end, we describe: the basic differences in approaches between the EU and the complaining parties with regard to genetically modified crops, what the main arguments were of the complaining parties as well as the defence of the EU, what the final judgement of the panel was and finally, we describe the current EU regulations. We then analyse to what extent, the arguments and conclusions of the panel still hold regarding the new EU legislation. We find that parts of the current EU legislation, that is, the safety bans as they are currently in place, are in breach of the WTO commitments. Moreover, the new approval procedures have the potential to also break these rules, although whether or not they will, depends on how the European Commission acts. Whether or not the EU will be challenged at the WTO remains an open question, as the decision to fight before the WTO may be more costly than working out new bilateral trade agreements.     

Oligopolistic markets with sequential search and production cost uncertainty

This article analyzes a sequential search model where firms face identical but stochastic production costs, the realizations of which are unknown to consumers. We characterize a perfect Bayesian equilibrium satisfying a reservation price property and provide a sufficient condition for such an equilibrium to exist. We show that (i) firms set on average higher prices and make larger profits compared to the scenario where consumers observe production costs, (ii) expected prices and consumer welfare can be non‐monotonic in the number of firms, and (iii) the impact of production cost uncertainty vanishes as the number of firms becomes very large.     

Board Team Leadership Revisited: A Conceptual Model of Shared Leadership in the Boardroom

In the slipstream of several large-scale corporate scandals, the board of directors has gained a pivotal position in the corporate governance debate. However, due to an overreliance on particular methodological (i.e. input–output studies) and theoretical (i.e. agency theory) research fortresses in past board research, academic knowledge concerning how this important governance mechanism actually operates and functions remains relatively limited. This theoretical paper aims to contribute to the promising stream of research which focuses on behavioural perspectives and processes within the corporate board, by delving into one of the research areas perhaps plagued most by these predominant approaches: board leadership. In adopting a team perspective on the board of directors our study goes beyond traditional board leadership research, which has turned a blind eye on actual leadership dynamics, by examining leadership processes and behaviours inside the board team. Specifically, we develop a conceptual framework addressing a novel and ethical approach to team leadership within the board, i.e. shared leadership, which has previously been demonstrated to result in performance benefits in various other team settings.     

Forced Freebies: A Note on Partial Deregulation with Pro Bono Supply Requirements

The liberalization of many former state governed natural monopolies in sectors such as electricity, railroad and telecommunications is done by partial deregulation. Typically, entry is invited into elements of the production chain, yet under strict price and quality controls. This note considers some potential welfare effects of an unconventional type of conditional deregulation, used in the electricity market in Flanders, Belgium, where the utility companies are held to deliver the households they supply a complimentary basic electricity package free of charge. It is shown that, while decreasing the number of new entrants into the liberalized market, such pro bono supply requirements can nevertheless increase net total production. A general condition for a welfare maximizing level of forced freebies is derived.     

Cycles and multiple equilibria in the market for durable lemons

Summary. The paper investigates the nature of market failure in a dynamic version of Akerlof (1970) where identical cohorts of a durable good enter the market over time. In the dynamic model, equilibria with qualitatively different properties emerge. Typically, in equilibria of the dynamic model, sellers with higher quality wait in order to sell and wait more than sellers of lower quality. The main result is that for any distribution of quality there exist an infinite number of cyclical equilibria where all goods are traded within a certain number of periods after entering the market. Received: December 21, 2000; revised version: September 5, 2001     

Bank profitability during recessions

This paper contributes to the literature on the relation between bank profitability and economic activity. When allowing for stronger co-movement of bank profit with economic activity during deep recessions, we find a much larger impact of output growth on bank profitability than commonly found in the literature. Among the different components of bank profit, loan losses are the main driver of this result. We also find long-term interest rates in previous years to be important determinants of bank profit in times of high economic growth. Our findings are robust to the use of aggregate or individual bank data.