Taxation of E-Commerce: Persistent Problems and Recent Developments

E-Commerce über das Internet bedeutet neue Herausforderungen für die Besteuerung. Im Bereich der Einkommens- und Unternehmensbesteuerung entsteht ein großes Potential zur Verlagerung von Einkünften in Niedrigsteuerländer, insbesondere durch Gestaltung von Verrechnungspreisen und durch Übertragung von immateriellen Wirtschaftsgütern. Längerfristig sind dadurch erhebliche Steuerausfälle zu befürchten. Bei der Umsatzsteuer (Mehrwertsteuer) entstehen Probleme, wenn ausländische Anbieter an inländische Endverbraucher elektronische Produkte oder Dienstleistungen online verkaufen. Die Mehrwertsteuer sollte in dem Land erhoben werden, wo der Verbrauch stattfindet, was gegenwärtig nicht der Fall ist, andernfalls drohen Wettbewerbsverfälschungen und ungerechte Steuerbelastungen. Dies erfordert besondere technische Lösungen sowie eine verstärkte internationale Kooperation der Finanzbehörden. Grundsätzlich sollte der e-commerce nicht steuerlich privilegiert werden, sondern sich aufgrund seiner spezifischen Wettbewerbsvorteile durchsetzen, andererseits sollte er aber auch nicht durch aufwendige steuertechnische Anforderungen behindert werden

Using Geographically Referenced Data on Environmental Exposures for Public Health Research: A Feasibility Study Based on the German Socio-Economic Panel Study (SOEP)

Background: In panel datasets information on environmental exposures is scarce. Thus, our goal was to probe the use of area-wide geographically referenced data for air pollution from an external data source in the analysis of physical health. Methods: The study population comprised SOEP respondents in 2004 merged with exposures for NO2, PM10 and O3 based on a multi-year reanalysis of the EURopean Air pollution Dispersion-Inverse Model (EURAD-IM). Apart from bivariate analyses with subjective air pollution we estimated cross-sectional multilevel regression models for physical health as assessed by the SF-12. Results: The variation of average exposure to NO2, PM10 and O3 was small with the interquartile range being less than 10µg/m3 for all pollutants. There was no correlation between subjective air pollution and average exposure to PM10 and O3, while there was a very small positive correlation between the first and NO2. Inclusion of objective air pollution in regression models did not improve the model fit. Conclusions: It is feasible to merge environmental exposures to a nationally representative panel study like the SOEP. However, in our study the spatial resolution of the specific air pollutants has been too little, yet.SOEP, Geographically Referenced Data, Feasibility Study, Air Pollution, EURAD-IM, Physical Health

Attitude is everything? The impact of workload, safety climate, and safety tools on medical errors: A study of intensive care units

Background: Hospitals face an increasing pressure towards efficiency and cost reduction while ensuring patient safety. This warrants a closer examination of the trade-off between production and protection posited in the literature for a high-risk hospital setting (intensive care). Purposes: Based on extant literature and concepts on both safety management and organizational/safety culture, this study investigates to which extent production pressure (i.e., increased staff workload and capacity utilization) and safety culture (consisting of safety climate among staff and safety tools implemented by management) influence the occurrence of medical errors and if/how safety climate and safety tools interact. Methodology / Approach: A prospective, observational, 48-hour cross-sectional study was conducted in 57 intensive care units. The dependent variable is the incidence of errors affecting those 378 patients treated throughout the entire observation period. Capacity utilization and workload were measured by indicators such as unit occupancy, nurse-/physician-to-patient ratios, levels of care, or NEMS scores. The safety tools considered include Critical Incidence Reporting Systems, audits, training, mission statements, SOPs/checklists and the use of barcodes. Safety climate was assessed using a psychometrically validated four-dimensional questionnaire. Linear regression was employed to identify the effects of the predictor variables on error rate, as well as interaction effects between safety tools and safety climate. Findings: Higher workload has a detrimental effect on safety while safety climate - unlike the examined safety tools - has a virtually equal opposite effect. Correlations between safety tools and safety climate as well as their interaction effects on error rate are mostly nonsignificant. Practice Implications: Increased workload and capacity utilization increase the occurrence of medical error; an effect that can be offset by a positive safety climate but not by formally implemented safety procedures and policies

Attitude is everything? The impact of workload, safety climate, and safety tools on medical errors: A study of intensive care units

Background: Hospitals face an increasing pressure towards efficiency and cost reduction while ensuring patient safety. This warrants a closer examination of the trade-off between production and protection posited in the literature for a high-risk hospital setting (intensive care). Purposes: Based on extant literature and concepts on both safety management and organizational/safety culture, this study investigates to which extent production pressure (i.e., increased staff workload and capacity utilization) and safety culture (consisting of safety climate among staff and safety tools implemented by management) influence the occurrence of medical errors and if/how safety climate and safety tools interact. Methodology / Approach: A prospective, observational, 48-hour cross-sectional study was conducted in 57 intensive care units. The dependent variable is the incidence of errors affecting those 378 patients treated throughout the entire observation period. Capacity utilization and workload were measured by indicators such as unit occupancy, nurse-/physician-to-patient ratios, levels of care, or NEMS scores. The safety tools considered include Critical Incidence Reporting Systems, audits, training, mission statements, SOPs/checklists and the use of barcodes. Safety climate was assessed using a psychometrically validated four-dimensional questionnaire. Linear regression was employed to identify the effects of the predictor variables on error rate, as well as interaction effects between safety tools and safety climate. Findings: Higher workload has a detrimental effect on safety while safety climate - unlike the examined safety tools - has a virtually equal opposite effect. Correlations between safety tools and safety climate as well as their interaction effects on error rate are mostly nonsignificant. Practice Implications: Increased workload and capacity utilization increase the occurrence of medical error; an effect that can be offset by a positive safety climate but not by formally implemented safety procedures and policies

Gradient regularity for a class of doubly nonlinear parabolic partial differential equations

In this paper, we study the local gradient regularity of non-negative weak solutions to doubly nonlinear parabolic partial differential equations of the type \begin{align*} \partial_t u^q - \mbox{div}\, A(x,t,Du)=0 \qquad\mbox{in $\Omega_T$}, \end{align*} with $q>0$, $\Omega_T=\Omega\times(0,T)\subset\mathbb{R}^{n+1}$ a space-time cylinder, and $A=A(x,t,\xi)$ a vector field satisfying standard $p$-growth conditions. Our main result establishes the local H\"older continuity of the spatial gradient of non-negative weak solutions in the super-critical fast diffusion regime $$0<p-1<q<\frac{n(p-1)}{(n-p)_+}.$$ This result is achieved by utilizing a time-insensitive Harnack inequality and Schauder estimates that are developed for equations of parabolic $p$-Laplacian type. Additionally, we establish a local $L^{\infty}$-bound for the spatial gradient

Below the Waterline: Developing a Transformational Learning Collaborative for Foundation Program Officers

Learning from fellow grantmakers is imperative in today’s ever-changing world. In late 2016, four health legacy foundations partnered to launch the Health Legacy Collaborative Learning Circle, creating an opportunity to understand not just the participating foundations’ visible investments and programs, but also the underlying behaviors, structures, and mindsets that ultimately explain why certain results were or were not achieved. This article describes the yearlong process of creating the collaborative, and presents a new learning framework — based on the iceberg metaphor — that can be used to create learning environments that test and expand assumptions about promising approaches to common population health challenges, explore organizational best practices related to programming and operations, and understand the roles and impacts peer health legacy foundations have in their communities. For the learning circle participants, the process provided a new and valuable problem-solving tool that allows their organizations to have a more profound impact on the communities they serve. This article concludes with recommendations for how other foundations can create similar transformational learning journeys with their fellow grantmakers