37 research outputs found
An Analysis of State Aid from Europe to New Zealand
Where state aid is distorting competition and creating inefficiencies it should and can be (self-)regulated. The European system of external monitoring and disciplines that the countries within the European Union are agreeing to have imposed on themselves has proven to reduce state aid levels and thereby increase overall welfare. Other than those that stem from its WTO commitments New Zealand has no such monitoring mechanisms or disciplines yet does as do many other countries provide state aid in various forms across different sectors of the economy including public services. It is therefore important to understand the rationales behind the provision of different types of state aid as well as its potentially negative effects on welfare. The European experience can then function as a benchmark for New Zealand and other countries in the Asia-Pacific region when considering the design of state aid rules in the future
The Nature of Services and the Implications for Competition Policy
Though 'services' is a very broad concept and any generalisations should be made with caution it is widely acknowledged that services differ from goods in many respects. Analyses of key elements of market structure conduct and performance and the interface between these elements show us that competition in services markets is equally distinctive. We find that traditional competition policy instruments generally do not reflect competition and performance in most services markets. Alternative policy measures should recognise the importance and disciplining power of non-price competition and the fact that quality and reputation are the main variables in services competition
The Development and Implication of Free ISPs in New Zealand
The New Zealand telecommunications experience illustrates the process of competition in a market for network services characterised by technological change and minimal regulation. The story of free ISPs is merely one episode in the battle of Telecom and Clear for the New Zealand telecommunications market. It was enabled by a complex combination of regulation contractual choices and an unanticipated surge of the Internet. Despite certain static inefficiencies the free ISPs have brought a considerable number of dynamic efficiencies that should be taken into account when evaluating New Zealand's light-handed policy regime in this industry
An Analysis of State Aid from Europe to New Zealand
Where state aid is distorting competition and creating inefficiencies it should and can be (self-)regulated. The European system of external monitoring and disciplines that the countries within the European Union are agreeing to have imposed on themselves has proven to reduce state aid levels and thereby increase overall welfare. Other than those that stem from its WTO commitments New Zealand has no such monitoring mechanisms or disciplines yet does as do many other countries provide state aid in various forms across different sectors of the economy including public services. It is therefore important to understand the rationales behind the provision of different types of state aid as well as its potentially negative effects on welfare. The European experience can then function as a benchmark for New Zealand and other countries in the Asia-Pacific region when considering the design of state aid rules in the future
The Nature of Services and the Implications for Competition Policy
Though 'services' is a very broad concept and any generalisations should be made with caution it is widely acknowledged that services differ from goods in many respects. Analyses of key elements of market structure conduct and performance and the interface between these elements show us that competition in services markets is equally distinctive. We find that traditional competition policy instruments generally do not reflect competition and performance in most services markets. Alternative policy measures should recognise the importance and disciplining power of non-price competition and the fact that quality and reputation are the main variables in services competition
One question might be capable of replacing the Shoulder Pain and Disability Index (SPADI) when measuring disability: a prospective cohort study
Questions: Is it possible to replace the Shoulder Pain and Disability Index (SPADI) with a single substitute question for people with shoulder pain, when measuring disability and how well does this substitute question perform as a predictor for recovery. Design: A prospective cohort study. Participants: A total of 356 patients with shoulder pain in primary care. Analyses: Convergent, divergent, and “known” groups validity were assessed by using hypotheses testing. Responsiveness was assessed using the Receiver Operating Curve and hypothesis testing. In addition, we performed multivariate regression to assess if the substitute question showed similar properties as the SPADI and if it affected the model itself, using recovery as an outcome. Results: The Spearman correlation coefficient between the total SPADI score and the substitute question was high, and moderate with the Shoulder Disability Questionnaire. The correlation between the substitute question and the EQ-5D-3L was low and the responsiveness was acceptable. The substitute question did not significantly contribute to both prognostic prediction models as opposed to the SPADI. Regardless all models showed poor to fair discrimination. Conclusion: The single question is a reasonable substitute for the SPADI and can be used as a screening instrument for shoulder disability in primary clinical practice. It has slightly poorer predictive power and should therefore not be used for prognosis
The use of rapid prototyped implants to simulate knee joint abnormalities for in vitro testing: a validation study with replica implants of the native trochlea
To investigate the biomechanical effect of skeletal knee joint abnormalities, the authors propose to implant pathologically shaped rapid prototyped implants in cadaver knee specimens. This new method was validated by replacing the native trochlea by a replica implant on four cadaver knees with the aid of cadaver-specific guiding instruments. The accuracy of the guiding instruments was assessed by measuring the rotational errors of the cutting planes (on average 3.01 degrees in extension and 1.18 degrees in external/internal rotation). During a squat and open chain simulation, the patella showed small differences in its articulation with the native trochlea and the replica trochlea, which could partially be explained by the rotational errors of the implants. This study concludes that this method is valid to investigate the effect of knee joint abnormalities with a replica implant as a control condition to account for the influence of material properties and rotational errors of the implant
A study protocol of external validation of eight COVID-19 prognostic models for predicting mortality risk in older populations in a hospital, primary care, and nursing home setting
BACKGROUND: The COVID-19 pandemic has a large impact worldwide and is known to particularly affect the older population. This paper outlines the protocol for external validation of prognostic models predicting mortality risk after presentation with COVID-19 in the older population. These prognostic models were originally developed in an adult population and will be validated in an older population (≥ 70 years of age) in three healthcare settings: the hospital setting, the primary care setting, and the nursing home setting.METHODS: Based on a living systematic review of COVID-19 prediction models, we identified eight prognostic models predicting the risk of mortality in adults with a COVID-19 infection (five COVID-19 specific models: GAL-COVID-19 mortality, 4C Mortality Score, NEWS2 + model, Xie model, and Wang clinical model and three pre-existing prognostic scores: APACHE-II, CURB65, SOFA). These eight models will be validated in six different cohorts of the Dutch older population (three hospital cohorts, two primary care cohorts, and a nursing home cohort). All prognostic models will be validated in a hospital setting while the GAL-COVID-19 mortality model will be validated in hospital, primary care, and nursing home settings. The study will include individuals ≥ 70 years of age with a highly suspected or PCR-confirmed COVID-19 infection from March 2020 to December 2020 (and up to December 2021 in a sensitivity analysis). The predictive performance will be evaluated in terms of discrimination, calibration, and decision curves for each of the prognostic models in each cohort individually. For prognostic models with indications of miscalibration, an intercept update will be performed after which predictive performance will be re-evaluated.DISCUSSION: Insight into the performance of existing prognostic models in one of the most vulnerable populations clarifies the extent to which tailoring of COVID-19 prognostic models is needed when models are applied to the older population. Such insight will be important for possible future waves of the COVID-19 pandemic or future pandemics.</p
A study protocol of external validation of eight COVID-19 prognostic models for predicting mortality risk in older populations in a hospital, primary care, and nursing home setting
BACKGROUND: The COVID-19 pandemic has a large impact worldwide and is known to particularly affect the older population. This paper outlines the protocol for external validation of prognostic models predicting mortality risk after presentation with COVID-19 in the older population. These prognostic models were originally developed in an adult population and will be validated in an older population (≥ 70 years of age) in three healthcare settings: the hospital setting, the primary care setting, and the nursing home setting.METHODS: Based on a living systematic review of COVID-19 prediction models, we identified eight prognostic models predicting the risk of mortality in adults with a COVID-19 infection (five COVID-19 specific models: GAL-COVID-19 mortality, 4C Mortality Score, NEWS2 + model, Xie model, and Wang clinical model and three pre-existing prognostic scores: APACHE-II, CURB65, SOFA). These eight models will be validated in six different cohorts of the Dutch older population (three hospital cohorts, two primary care cohorts, and a nursing home cohort). All prognostic models will be validated in a hospital setting while the GAL-COVID-19 mortality model will be validated in hospital, primary care, and nursing home settings. The study will include individuals ≥ 70 years of age with a highly suspected or PCR-confirmed COVID-19 infection from March 2020 to December 2020 (and up to December 2021 in a sensitivity analysis). The predictive performance will be evaluated in terms of discrimination, calibration, and decision curves for each of the prognostic models in each cohort individually. For prognostic models with indications of miscalibration, an intercept update will be performed after which predictive performance will be re-evaluated.DISCUSSION: Insight into the performance of existing prognostic models in one of the most vulnerable populations clarifies the extent to which tailoring of COVID-19 prognostic models is needed when models are applied to the older population. Such insight will be important for possible future waves of the COVID-19 pandemic or future pandemics.</p
Non-invasive risk scores for prediction of type 2 diabetes (EPIC-InterAct) : a validation of existing models
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