Cost-effectiveness of treatments for superficial venous refluxin patients with chronic venous ulceration.

Background Venous leg ulcers impair quality of life significantly, with substantial costs to health services. The aim of this study was to estimate the cost‐effectiveness of interventional procedures alongside compression therapy versus compression therapy alone for the treatment of chronic venous leg ulceration. Methods A Markov decision analytical model was developed. The main outcome measures were quality‐adjusted life‐years (QALYs) and lifetime costs per patient, from the perspective of the UK National Health Service at 2015 prices. Resource use included the initial procedures, compression therapy, primary care and outpatient consultations. The interventional procedures included superficial venous surgery, endothermal ablation and ultrasound‐guided foam sclerotherapy (UGFS). The study population was patients with a chronic venous ulcer who were eligible for either compression therapy or an interventional procedure. Data were obtained from systematic review and meta‐analysis of RCTs. Results Surgery gained 0·112 (95 per cent c.i. −0·011 to 0·213) QALYs compared with compression therapy alone, with a difference in lifetime costs of €−1330 (−3570 to 1262). Given the expected savings in community care, the procedure would pay for itself within 4 years. There was insufficient evidence regarding endothermal ablation and UGFS to draw conclusions. Discussion This modelling study found surgery to be more effective and less costly than compression therapy alone. Further RCT evidence is required for both endothermal ablation and UGFS

The Brand is the Bundle Strategies for the Mobile Ecosystem

The current mobile ecosystem is best understood in terms of a monopolistic competition model, characterised by heterogeneous producers providing a range of differentiated products for consumers with heterogeneous preferences. Product differentiation offers producers some market power, ultimately constrained by imperfect substitutes from rivals and the threat of market entry. To achieve their goals, consumers require a mixture of products from the network, handset and application domains. Reduced search and other transaction costs are a demand-side benefit of product bundling. Producers in this market have high fixed costs and low marginal costs. High fixed costs discourage entry, which increases the market power of producers. Low marginal costs and uncorrelated customer preferences across products for individual consumers encourage producers to expand their sales using supply-side bundling. Thus there are strong supply and demand side benefits from product bundling. We argue that producers will compete in terms of differentiated bundles combining network, handset and application features, with branding as the essential strategy for bundle differentiation. Successful business strategies will require direct access to customers and information about their specific preferences. For illustration, we look at the currently apparent strategies of Google, Apple and Nokia. The mobile ecosystem is complex but not unique. Strong parallels can be drawn between the mobile ecosystem and the television ecosystem. Google appears to be following a "free to air" strategy and Apple a "pay TV" strategy in bundle differentiation. Television manufacturers are largely undifferentiated and have little market power: this may be the fate of handset manufacturers and network operators who are comparatively powerless to withstand the evolutionary development of the mobile ecosystem.Business ecosystem, platform, monopolistic competition, product bundling, heterogeneous demand, business strategies, mobile telephony, mobile applications, branding, price discrimination.

UFBI 2.0: Revised separation boundaries may partially address pricing and uptake limitations in New Zealand fibre broadband model, but significant competition policy problems remain

On July 1 2010, the Minister of Communications Steven Joyce announced fundamental changes to the structure and regulation of the New Zealand Government's Ultra-Fast Broadband Initiative. The changes were deemed necessary in order to achieve uptake targets sufficient to underpin the business case for both government and private sector investment. Whilst the changes would appear to enable progress towards the ability to access productive scale efficiencies and competitive pricing structures that will induce some degree of substitution, lack of clarity about the future competitive environment still exposes investors in the sector to significant uncertainties and potential perverse outcomes. Consequently, overall sector investment will likely be inhibited, and the evolution of broadband sector institutions substantially constrained

Regulatory Implications of Structural Separation

This submission was prepared as a response to the Ministry of Economic Development's discussion document Regulatory Implications of Structural Separation

Can continuous disclosure improve the performance of State-Owned Enterprises?

In January 2010 the New Zealand Government introduced a continuous disclosure regime for State-Owned Enterprises (SOEs) modelled on the regime applying to publicly-listed companies (PLCs). The government sees continuous disclosure increasing the transparency of SOEs and that this will lead to improved financial performance by SOEs. We analyse the traditional rationales for continuous disclosure in PLCs and find that it is not axiomatic that a continuous disclosure regime designed for PLCs overlaid onto an SOE will offer the same incentives for performance improvement. The differences in owner identity and governance relationships in SOEs and the absence of a market for the trading of shares substantially weaken the performance improvement effect of the disclosure instrument in SOEs. In the absence of share trading it is not clear how a failure to disclose by SOE managers could be detected. Furthermore under the New Zealand arrangements the sanctions for SOE failure to disclose are very weak. This suggests that it is both easier for and more likely that SOE managers will withhold material information relative to their PLC counterparts. The hypothesis appears confirmed by a matched-pair comparison of disclosures by SOEs and private sector firms in the first year of the SOE continuous disclosure regime

En busca del lector implícito en tres versiones del relato de la niña obediente

Este trabajo es un análisis comparativo de "El cuentista" de Saki, el "Cuento de la niña condecorada" de Jorge Ibargüengoitia e Hipersúper Jezabel de Tony Ross, tres obras destinadas directa o indirectamente a un receptor infantil que comparten un mismo arquetipo o motivo: el de la niña obediente y súper perfecta, alejada del comportamiento característico de la infancia y próxima al mundo adulto y al modelo de conducta que éste habitualmente promueve. A partir de la comparación de las semejanzas y diferencias entre estas tres versiones del relato de la niña obediente, y desde la óptica de la teoría de la recepción, se hace patente el papel que cumple el lector implícito como un elemento intrínseco a la configuración artística de la obra. Mediante el uso de distintos recursos, las tres obras plantean desde su estructura misma la presencia de un lector activo que se anticipa a los hechos, pone en funcionamiento los juegos irónicos y humorísticos, desentraña el sentido, interpreta, y ante todo genera esa mágica alianza obra-lector que insufla vida al texto. En este ensayo se descubren paso a paso las huellas de un lector predeterminado en tres cuentos en los que destaca la crítica a un personaje que en su búsqueda por alcanzar la perfección incurre en el horror de encarnarla