Trends and Variation in End-of-Life Care for Medicare Beneficiaries With Severe Chronic Illness

Provides an updated analysis of regional and hospital variations in end-of-life care for Medicare beneficiaries with chronic illnesses, including percentage of hospital deaths, days in intensive care units, and physician labor per patient

DAMPAK PERSONALISASI PARTAI TERHADAP DEMOKRASI INTERNAL PARTAI DI INDONESIA PASCA ORDE BARU

Partai politik merupakan salah satu instrumen yang penting dalam membangun demokrasi. Namun, disaat partai politik dewasa ini dituntut untuk menjadi partai modern yang menjalankan aktivitasnya secara legal dan rasional, di era reformasi partai justru terjerumus dalam berbagai persoalan, salah satunya adalah masalah personalisasi partai politik. metode kualitatif eksplanatori dengan menjelaskan fenomena personalisasi politik dalam PDI Perjuangan, Partai Gerindra, dan Partai Nasdem, diketahui bahwa faktor penyebab partai masih didominasi oleh satu figur/individu tertentu adalah kharisma figur,kultur patron-klien, dan motif ekonomi. Sekalipun beberapa studi terdahulu menyatakan bahwa personalisasi partai politik dalam kondisi tertentu menguntungkan partai untuk menjaga soliditas partai, studi menemukan bahwa dampak positif tersebut hanyalah dampak yang bersifat semu dan jangka pendek. Personalisasi partai politik tidak dapat dimaklumi dan dikompromikan karena fenomena tersebut berdampak pada bangunan partai politik yang dibangun dari sistem ketergantungan pada figur-figur tertentu yang dapat berperan secara holistik bagi partainya. Lebih lanjut, kondisi ini mengancam demokrasi internal partai yang membuat institusionalisasi partai politik menjadi terhambat, matinya demokrasi internal partai, hingga dampak buruk pada sirkulasi elit

Environmental changes and violent conflict

This letter reviews the scientific literature on whether and how environmental changes affect the risk of violent conflict. The available evidence from qualitative case studies indicates that environmental stress can contribute to violent conflict in some specific cases. Results from quantitative large-N studies, however, strongly suggest that we should be careful in drawing general conclusions. Those large-N studies that we regard as the most sophisticated ones obtain results that are not robust to alternative model specifications and, thus, have been debated. This suggests that environmental changes may, under specific circumstances, increase the risk of violent conflict, but not necessarily in a systematic way and unconditionally. Hence there is, to date, no scientific consensus on the impact of environmental changes on violent conflict. This letter also highlights the most important challenges for further research on the subject. One of the key issues is that the effects of environmental changes on violent conflict are likely to be contingent on a set of economic and political conditions that determine adaptation capacity. In the authors' view, the most important indirect effects are likely to lead from environmental changes via economic performance and migration to violent conflict. © 2012 IOP Publishing Ltd

Driving pro-environmental change in tourist destinations: encouraging sustainable travel in National Parks via partnership project creation and implementation

© 2016 Taylor & Francis. This paper explores a key challenge in introducing more sustainable transport practices at destinations: achieving modal shift in visitor travel from cars to physically active or public transport to reduce tourism's environmental impacts. It centres on using partnership led projects bringing together the many public and private sector organisations involved, to drive destination change and development. To date, research has centred on pro-environmental change for individuals and individual organisations: little is known about the mechanisms of pro-environmental change via complex multi-partner organisations. The paper reports research into the processes involved in successful projects to provide alternatives to car travel in three UK National Parks by using partnerships to obtain funding and implement change. Based on case studies informed by in-depth interviews with key stakeholders involved in pro-environmental change implementation, narratives are analysed to explain the change process, and mapped against existing literature and theories of change. Conclusions show the role of inspired individuals, supportive senior management, strong governance, better visitor experiences and, most significantly, communication and communication of the benefits of change to stakeholders. The research suggests why and how change occurs in partnerships, contributes to better theories of change and offers guidance on understanding and implementing change processes worldwide

Which Green Matters for Whom? Greening and Firm Performance across Age and Size Distribution of Firms.

A growing body of literature links firm performance with sustainability efforts.We contribute to this literature by developing a novel framework for contextualising greening through the lens of tangibility and visibility of greening activities and examine the impact of different types of greening on firm performance along the age and size distribution of firms. The empirical results based on a large-scale database suggest that rewards to different types of greening differ across age and size distributions

Consumers’ values and behaviour in the Brazilian coffee-in-capsules market: Promoting circular economy

Coffee consumption is changing. Monodose, flavoured coffee capsules provide new experiences beyond the traditional custom of brewing coffee. While these pods mean access to a selection of premium coffee worldwide, they create huge quantities of plastic-aluminium packaging waste. This paper examines the novelty of coffee capsule consumption in Brazil in terms of consumers’ perspectives about ethical enterprise and environmental stewardship. We argue for ‘waste to resource’ management and applying reverse logistics to the coffee production supply chain. Based on Circular Economy principles and fuelled by the ‘green’ awareness of Brazilian coffee consumers themselves, we propose a conceptual framework to support business decision-making by adopting a systemic intervention from the consumer viewpoint. To structure and scope the problematic situation, we conducted over 40 interviews, using purposive sampling. Analytic Hierarchy Process (AHP), Value Focused Thinking (VFT) and Rich Picture Technique also informed our problem structuring approach. Findings illustrate that the ambition for a reverse supply chain in coffee capsule manufacturing presents real challenges to achieving circular practice. Yet, the eco-values of Brazilian coffee enthusiasts may be partly considered a ‘wealth of information flow’ and a potential driving force for change. This paper should be of interest to researchers and practitioners exploring how consumers may contribute to behavioural change, towards more circular business