Future of the status of regulated profession in Europe: Based on the analysis by Étienne LAMPERT, vice president of the association of chartered accountants and coordinator of French CLIO

Although the function and organisation of professions are not contested by the French authorities, their special status has been challenged recently by the European Union, in an attempt to reduce the current level of regulations, based on the principle of the free circulation of workers and competition law. The author reports recent facts which have alerted these regulated professions. The professional organisations responded to these attacks by declaring that regulations are designed to guarantee the safety of European users and consumers. The author describes the guarantees protecting the interests of both the professionals and their clients or patients: guarantees of competence, probity, independence, personal liability, confidentiality and professional secrecy. To ensure that these professional rules are correctly implemented, parapublic or private regulatory organisations must be set-up, with legal and financial power suited to the nature of their prerogatives, i.e. power to monitor the activity and to take disciplinary measures, elaboration of rules of professional conduct or of a code of deontology. The European desire to improve the free circulation of services for all regulated professions will eventually lead to a reduction in regulatory constraints. These professions will therefore have to watch these changes and modify their own rules accordingly as appropriate. The veterinary profession took a novel step by creating within the European Veterinary Federation a new section responsible for the accreditation to practice within the countries of the European Union. The assignments of this structure are briefly described.Si la fonction et l'organisation des professions libérales ne sont pas contestées par les pouvoirs publics français, ce statut particulier a connu dernièrement au niveau européen un certain nombre d'offensives ayant pour objectif implicite d'abaisser le niveau de réglementation existant, au nom du principe de la libre circulation des travailleurs et du droit de la concurrence. Des faits récents sont rapportés, mettant en alerte ces professions réglementées. En face de ces offensives, leur réponse est de garantir la sécurité des usagers et des consommateurs européens. Il est ainsi rappelé les garanties qui doivent assurer l'équilibre contractuel dans les relations entre les professionnels libéraux et leurs clients ou patients: garanties de compétence, de probité et d'indépendance, de responsabilité personnelle, de confidentialité et de secret professionnel. L'exigence de respect de ces règles professionnelles justifie et impose l'existence d'organismes de régulation parapublics ou privés dotés des pouvoirs juridiques et financiers appropriés à la nature de leurs prérogatives: pouvoir de surveillance, pouvoir disciplinaire, élaboration de règles de conduite professionnelle ou codé de déontologie. Pour l'ensemble des professions réglementées, la volonté européenne d'améliorer la libre circulation des services se manifeste par une perspective d'allégement des contraintes réglementaires. Il leur faut donc rester attentives à ces évolutions et procéder à l'examen de leurs propres règles en vue de préparer, le cas échéant, les aménagements nécessaires. En ce qui concerne la profession vétérinaire, une démarche originale a consisté à créer au sein de la Fédération Vétérinaire Européenne, une nouvelle section regroupant les services d'habilitation à l'exercice, des pays membres de l'Union. Les missions de cette structure sont évoquées

Conduct code project for veterinary surgeons submitted by the Order high Council to the government for promulgation of a decret examined by State council

Doté d’un pouvoir réglementaire, le Conseil Supérieur de l’Ordre éla bore un Code de déontologie qui nécessite au fil du temps des refontes en fonction des évolutions que connaît la profession auquel il s'applique dans un environnement social lui-même très changeant. L’étude présentée porte sur le dernier projet soumis par le Conseil Supérieur de l’Ordre au Gouvernement. Au-delà de quelques modifications de forme, les principales évolutions prises en compte concernent l’information du public, la publicité, les activités annexes, la dénomination « clinique vétérinaire », l’association des vétérinaires exerçant à distance. Le Conseil d’Etat étudie actuellement ce texte avant d’en proposer une version définitive au Gouvernement pour promulgation sous forme de décret.Endowed with statutory powers, the supreme Council of Veterinary Surgeons is drawing up a Code of conduct, wich will require modifications in the course of time, according to the changes undergone by the profession to which it applies in a social environment which itself is always changing. The study which is presented deals with the latest scheme submitted by the supreme Council of Veterinary Surgeons to the Government. Beyond a few modifications of form, the main changes concern the information of the public, advertising, supplementary activities, the right to use the name « veterinary clinic », the association of veterinary surgeons working at a distance. The Council of State is at this moment examining this text, before proposing a final version to the Government for promulgation in the shape of an official order

Social Preferences and Voting: An Exploration Using a Novel Preference Revealing Mechanism

Public referenda are frequently used to determine the provision of public goods. As public programs have distributional consequences, a compelling question is what role if any social preferences have on voting behavior. This paper explores this issue using laboratory experiments wherein voting outcomes lead to a known distribution of net benefits across participants. Preferences are elicited using a novel Random Price Voting Mechanism (RPVM), which is a more parsimonious mechanism than dichotomous choice referenda, but gives consistent results. Results suggest that social preferences, in particular a social efficiency motive, lead to economically meaningful deviations from self-interested voting choices and increase the likelihood that welfare-enhancing programs are implemented.Institutional and Behavioral Economics, Research Methods/ Statistical Methods, C91, C92, D64, D72, H41,

ANOMALIES IN VOTING: AN EXPERIMENTAL ANALYSIS USING A NEW, DEMAND REVEALING (RANDOM PRICE VOTING) MECHANISM

This study investigates the influence of social preferences on voting decisions using a new Random Price Voting Mechanism (RPVM), which is best thought of as a public goods voting extension of the Becker-DeGroot-Marshack mechanism for private goods. In particular, this mechanism is used to investigate experimentally whether voting decisions are affected by the distribution of net benefits associated with a proposed public program. Recent papers have shown that, in additional to selfishness, factors such as inequality aversion, maximin preferences, and efficiency may influence individual decisions. However, the effect of social preferences on voting, the predominant funding mechanism for public goods by legislatures and public referenda, has not been thoroughly examined. We first establish the presence of anomalous behavior in dichotomous voting, and introduce the RPVM as a more efficient mechanism to examine such anomalies. We show that it is demand revealing in the presence of social preferences and empirically consistent with dichotomous choice voting. Laboratory experiments involving 440 subjects show that when net benefits are homogeneously distributed, the new RPVM is demand-revealing in both willingness-to-pay (WTP) and willingness-to-accept (WTA) settings, for both gains and losses. When the voting outcome potentially results in a heterogeneous distribution of (net) benefits, a systematic wedge appears between individuals' controlled induced values and their revealed WTP or WTA. With induced gains, the best-off subjects under-report their WTP and WTA in comparison to their induced value. Worst-off subjects express WTP and WTA that exceed their induced value. With induced losses a mirror image is evident. Best-off subjects over-report their induced value while the worst-off subjects under-report. Theoretical and econometric results presented in the paper suggest that these differences are caused by a concern for social efficiency.Institutional and Behavioral Economics,

Changes in the veterinary code of ethics

The transposition of Directive 2006/123/EC into national law applies to veterinarians. The Veterinary Council has raised the issue with the aim to provide the profession with new tools to regulate the practice of animal medicine and surgery. The proposals promote a simple idea, i.e. to let veterinarians open several private practices or several veterinary companies, in return for genuine regulation. They are based on the concept of a single administrator controlling the practices, backed by proper general terms and conditions. Six aspects were examined: practice limited to one company, limited number of practices and annexes, limited number of employees or self-employed collaborators, a single administrative office, location in commercial premises and communication. These proposals should be finalised by the publication of a new code of ethics expected in 2011.La transposition de la Directive 2006/123/CE, en droit national, concerne les vétérinaires. L’Ordre vétérinaire a porté le dossier avec pour objectif de doter la profession de nouveaux outils pour encadrer l’exercice de la médecine et de la chirurgie des animaux. Les propositions reposent sur une idée simple qui est d’accepter l’ouverture de l’exercice dans plusieurs domiciles professionnels d’exercice ou dans plusieurs sociétés vétérinaires, en contrepartie d’une véritable régulation du dispositif. Elles reposent sur la notion d’administrateur de domicile professionnel d’exercice et sur la rédaction des conditions générales de son fonctionnement. Six thématiques vétérinaires ont fait l’objet d’une évaluation: les limitations à l’exercice au sein d’une société, la limitation du nombre de domiciles professionnels d’exercice et annexes, la limitation du nombre de salariés ou de collaborateurs libéraux, l’unicité du domicile professionnel administratif, l’installation dans des locaux commerciaux et la communication. Le dispositif final devrait être stabilisé par la publication d’un nouveau code de déontologie attendu en 2011

Services directive : what, why, how?

EU Directive 2006/123/EC aims to facilitate freedom of establishment for service providers in other Member States and the freedom of provision of services between Member States. It also aims to promote economic growth and employment in the EU, as well as high quality services. Member states are obliged to modify their domestic law to remove any obstacles impeding the smooth development of the service activity within the Community. Requirements leading to an unjustified ban have been removed. Some national requirements are maintained if they meet the three following criteria: necessity, proportionality, and non-discrimination. France has fulfilled its obligations by writing two reports early 2010, which, once they have gone through the process of mutual evaluation by the Member States and have been accepted, will lead to a definition of the practical means of transposing the Directive into national law.L’Union Européenne institue, par la directive 2006/123/CE, un mécanisme visant à faciliter le libre établissement et la libre circulation des services et des personnes au sein d’un « grand marché intérieur des services ». Cette directive a pour objectif de favoriser la croissance économique et l'emploi dans l'UE, tout en prônant une haute qualité des services. Les États membres ont obligation de faire évoluer leur droit interne pour lever tout obstacle entravant le bon développement de l’activité de services communautaire. Les exigences induisant une interdiction non justifiée sont supprimées. Certaines exigences nationales sont sauvegardées si elles répondent aux trois critères de nécessité, de proportionnalité et de non discrimination. La France a répondu à ses obligations en rédigeant deux rapports, début 2010, qui après une évaluation mutuelle par les États membres et après acceptation, ouvriront à la définition des modalités pratiques d’application de la directive, dans le droit national

Truth in Consequentiality: Theory and Field Evidence on Discrete Choice Experiments

This paper explores methodological issues surrounding the use of discrete choice experiments to elicit values for public goods. We develop an explicit game-theoretic model of individual decisions to a series of choice sets, providing general conditions under which surveys with repeated binary choices are incentive compatible. We complement the theory with a framed field experiment, with treatments that span the spectrum from incentive compatible, financially binding decisions to decisions with no direct financial consequences. The results suggest truthful preference revelation is possible in surveys, provided that respondents view their decisions as having more than a weak chance of influencing policy. Cette étude s’intéresse à des aspects méthodologiques associés à l’utilisation d’expériences avec choix discrets pour évaluer des biens publics. Nous avons développé un modèle explicite de jeux théoriques pour des décisions individuelles à des séries de choix, avec conditions générales sous lesquelles un questionnaire avec des choix binaires répétés incite la révélation des valeurs. Ce développement théorique est suivi d’expériences terrains avec traitements qui couvrent le spectre des incitatifs de la révélation des valeurs, passant de la décision avec mise en place réelle du projet et paiements réels de la part des participants, à celle sans aucune conséquence financière directe et avec projets hypothétiques. Les résultats indiquent qu’il est possible d’obtenir une révélation des valeurs réelles en situation hypothétique, si les participants pensent que leurs décisions ont un potentiel d’impact significatif sur une éventuelle politique.discrete choice experiment, framed field experiment, mechanism design theory, stated preferences, consequentiality , expériences avec choix discrets; expérience terrain; préférences révélées; conséquences, biais hypothétique

Multicenter trial of one HLA-DR–matched or mismatched blood transfusion prior to cadaveric renal transplantation

Multicenter trial of one HLA-DR–matched or mismatched blood transfusion prior to cadaveric renal transplantation.BackgroundThe beneficial effect of blood transfusions before cadaveric renal transplantation on allograft survival, although previously well documented, has become controversial in light of their adverse effects. Recently, it has been suggested that their clinical benefits are due to HLA-DR sharing between the blood donor and recipient.MethodsIn this prospective study, 144 naive patients were randomly assigned to receive one unit of blood matched for one-HLA-DR antigen (N = 49), or one unit of mismatched blood (N = 48), or to remain untransfused (N = 47). Graft survival and acute rejection rate were analyzed in 106 cadaveric renal allograft recipients receiving the same immunosuppressive protocol.ResultsGraft survival was similar in the three groups at one and five years: 91.7 and 80% in untransfused patients, 90.3 and 79.3% in patients transfused with one DR-antigen–matched unit, and 92.3 and 83.7% in patients transfused with HLA-mismatched blood. The difference in the incidence of six-month post-transplant acute rejections was not statistically significant in the three groups: 12 out of 36, 33.3% in nontransfused patients; 6 out of 31, 19.4% in patients transfused with one DR-matched blood; and 13 out of 39, 33.3% in patients transfused with mismatched blood.ConclusionThe results of our prospective randomized trial showed that in a population of naive patients, one transfusion mismatched or matched for one HLA-DR antigen given prior to renal transplantation had no significant effect on the incidence and severity of acute rejection, and did not influence overall long-term graft outcome. Considering the potentially deleterious adverse effects of blood transfusions, the costs, and the considerable logistical efforts required to select and type blood donors, such a procedure cannot be recommended in a routine practice for patients awaiting cadaveric kidney transplantation

How to assess the role of Pt and Zn in the nephrotoxicity of Pt anti-cancer drugs?: An investigation combining μXRF and statistical analysis. Part II: Clinical application

International audienceIn this contribution, an approach developed previously for mice is used for human biopsy. In the case of patient 1, Pt detection is performed 6 days after the last oxaliplatin infusion, while for patient 2, the biopsy was performed more than 15 days after his first platin infusion and several dialysis. Even for these biological samples, experiments show that synchrotron mediated mXRF is a suitable tool to detect Pt in kidney biopsy, and thus probably for any organ exposed to Pt. Therefore, mXRF could also be of major interest to decipher the mechanism beyond Pt induced neurotoxicity, ototoxicity on human biopsy. Pharmacoavailability of chemotherapies is a major concern because some treatment failures are explained by poor tumor penetration of the active molecule. mXRF could be an elegant way to map the distribution of Pt inside cancerous cells at the micrometer scale. Pt and Zn are only two of the numerous trace elements that mXRF can detect; heavy metal intoxication diagnosis and the toxicity mechanism probably could also benefit from this innovative technique

Assessing an organizational culture instrument based on the Competing Values Framework: Exploratory and confirmatory factor analyses

BACKGROUND: The Competing Values Framework (CVF) has been widely used in health services research to assess organizational culture as a predictor of quality improvement implementation, employee and patient satisfaction, and team functioning, among other outcomes. CVF instruments generally are presented as well-validated with reliable aggregated subscales. However, only one study in the health sector has been conducted for the express purpose of validation, and that study population was limited to hospital managers from a single geographic locale. METHODS: We used exploratory and confirmatory factor analyses to examine the underlying structure of data from a CVF instrument. We analyzed cross-sectional data from a work environment survey conducted in the Veterans Health Administration (VHA). The study population comprised all staff in non-supervisory positions. The survey included 14 items adapted from a popular CVF instrument, which measures organizational culture according to four subscales: hierarchical, entrepreneurial, team, and rational. RESULTS: Data from 71,776 non-supervisory employees (approximate response rate 51%) from 168 VHA facilities were used in this analysis. Internal consistency of the subscales was moderate to strong (α = 0.68 to 0.85). However, the entrepreneurial, team, and rational subscales had higher correlations across subscales than within, indicating poor divergent properties. Exploratory factor analysis revealed two factors, comprising the ten items from the entrepreneurial, team, and rational subscales loading on the first factor, and two items from the hierarchical subscale loading on the second factor, along with one item from the rational subscale that cross-loaded on both factors. Results from confirmatory factor analysis suggested that the two-subscale solution provides a more parsimonious fit to the data as compared to the original four-subscale model. CONCLUSION: This study suggests that there may be problems applying conventional CVF subscales to non-supervisors, and underscores the importance of assessing psychometric properties of instruments in each new context and population to which they are applied. It also further highlights the challenges management scholars face in assessing organizational culture in a reliable and comparable way. More research is needed to determine if the emergent two-subscale solution is a valid or meaningful alternative and whether these findings generalize beyond VHA