The effects of provider control of Blue Shield plans : regulatory options / BEBR No. 645

Title page includes summary.Includes bibliographical references (p. 30-32)

Does Managed Care Change the Mission of Nonprofit Hospitals? Evidence From the Managerial Labor Market

This paper examines how the managerial labor market in nonprofit hospitals has adjusted to the negative income pressures created by HMO penetration. Using a panel of about 1500 nonprofit hospitals over the period 1992 to 1996, we find that top executive turnover increases following an increase in HMO penetration. Moreover, the increase in turnover is concentrated among the hospitals that have low levels of economic profitability and are more financially leveraged. While the link between top executive pay and for-profit performance measures is on average very weak, HMO penetration substantially tightens that link: as HMO penetration increases, top executives are compensated more for improving the profitability of their hospitals. These results are consistent with the view that HMO penetration increases the importance of for-profit performance objectives among not-for-profit hospitals. Boards appear to fire the managers that are least able to compete in the new competitive environment and reward incumbent managers more for achieving for-profit goals. Consistent with donors' belief that these changes represent a weakening of the nonprofit mission and not simply an attempt by altruistic boards to protect intergenerational equity, we find that public donations fall as HMO market share increases.

Does Managed Care Change the Management of Nonprofit Hospitals?

This paper examines how the managerial labor market in nonprofit hospitals has adjusted to the financial pressures induced by HMO penetration. Using a panel of about 1,500 nonprofit hospitals over the period 1992–96, the authors find that top executive turnover increased following an increase in HMO penetration. Moreover, the increase in turnover was concentrated among the hospitals that had lower levels of economic profitability. While the link between top executive pay and for-profit performance measures was on average very weak, HMO penetration tightened that link: as HMO penetration increased, top executives were compensated more for improving the profitability of their hospitals. These results, while of limited economic magnitude, are qualitatively consistent with the view that HMO penetration has increased the weight assigned to for-profit performance in the management of not-for-profit hospitals

EQL-CE: An Event Query Language for Connected Environments

International audienceRecent advances in sensor technology and information processing have allowed connected environments to impact various application domains. In order to detect events in these environments, existing works rely on the sensed data. However, these works are not re-usable since they statically define the targeted events (i.e., the definitions are hard to modify when needed). Here, we present a generic framework for event detection composed of (i) a representation of the environment; (ii) an event detection mechanism; and (iii) an Event Query Language (EQL) for user/framework interaction. This paper focuses on detailing the EQL which allows the definition of the data model components, handles instances of each component, protects the security/privacy of data/users, and defines/detects events. We also propose a query optimizer in order to handle the dynamicity of the environment and spatial/temporal constraints. We finally illustrate the EQL and conclude the paper with some future works

EQL-CE: An Event Query Language for Connected Environment Management

International audienceRecent technological advances have fueled the rise of connected environments (e.g., smart buildings and cities). Event Query Languages (EQL) have been used to define (and later detect) events in these environments. However, existing languages are limited to the definition of event patterns. They share the following limitations: (i) lack of consideration of the environment, sensor network, and application domain in their queries; (ii) lack of provided query types for the definition/handling of components/component instances; (iii) lack of considered data and datatypes (e.g., scalar, multimedia) needed for the definition of specific events; and (iv) difficulty in coping with the dynamicity of the environments. To address the aforementioned limitations, we propose here an EQL specifically designed for connected environments, denoted EQL-CE. We describe its framework, detail the used language, syntax, and queries. Finally, we illustrate the usage of EQL-CE in a smart mall example

Segmenter les paysages de l'eau : une méthode pour l'interprétation hydrodynamique des paysages (dorsale tunisienne)

International audienceThe problem of water appears to be the critical path in the analysis of Mediterranean landscapes, especially in Tunisia, where such regions are developed so as to assure better control of water. This study focused on two small watersheds belonging to a network of watersheds defined and followed by the IRD-Tunis within the framework of the AMBRE program. The importance and complementarity between photo-interpretation and ground techniques are emphasized in this work. This article offers answers to certain questions concerning landscape matters by approaching them from the “Science of the landscape” point of view, here meaning the hydrodynamic segmentation of the landscape. The study aims at delimiting and better understanding the organization of landscapes in segments and their hydrodynamic behaviour at the level of the watersheds, as well as the global impact of development on these surroundings. We ask how the landscapes are organized, what their hydrodynamic behaviours are, the impact of development in these Mediterranean surroundings and whether the notion of landscape segmentation, derived from the method of “Science of the landscape,” is pertinent to furthering the understanding of these landscape dynamics.Le problème de l'eau apparaît comme le fil conducteur essentiel de l'analyse des paysages méditerranéens, particulièrement en Tunisie où ces milieux sont entièrement aménagés dans le sens d'une plus grande maîtrise de l'eau. Cette étude a été réalisée sur deux petits bassins-versants situés dans la Dorsale tunisienne, qui font partie d'un réseau de bassins-versants défini et suivi par l'Institut de recherche pour le développement (IRD)-Tunis dans le cadre du programme AMBRE. L'accent est mis sur l'importance et la complémentarité des techniques de photo-interprétation et de terrain. Cet article cherche à apporter des réponses aux questionnements paysagers abordés sous l'angle de la « Science du paysage » – appliquée ici à la segmentation hydrodynamique des paysages. Cette recherche vise à mieux cerner et comprendre l'organisation des paysages en segments, leurs comportements hydrodynamiques à l'échelle du bassin-versant, ainsi que l'impact global des aménagements sur ces milieux. Comment s'organisent les paysages ? Quels sont les comportements hydrodynamiques de ces derniers ? Quel est l'impact de tous les aménagements réalisés dans ces milieux méditerranéens ? La notion de segmentation du paysage, extraite de la méthode de la « Science du paysage » est-elle pertinente dans la compréhension de ces dynamiques paysagères

Why do the Indians Wear Adidas? Or, Culture Contact and the Relations of Consumption

The study of the consumption of goods has never achieved the prominence in anthropology of either production or exchange. Yet the accelerating consumption of western goods in non-western societies is one of the most obtrusive cultural and economic trends of the last three centuries. This article addresses the general issue of why goods flow between cultural groups by re-examining the concept of consumption. It raises questions of importance to studies of development, material culture, ethnohistory, and symbolic anthropology

Light element abundances in carbon-enhanced metal-poor stars

We model the evolution of the abundances of light elements in carbon-enhanced metal-poor (CEMP) stars, under the assumption that such stars are formed by mass transfer in a binary system. We have modelled the accretion of material ejected by an asymptotic giant branch star on to the surface of a companion star. We then examine three different scenarios: one in which the material is mixed only by convective processes, one in which thermohaline mixing is present and a third in which both thermohaline mixing and gravitational settling are taken in to account. The results of these runs are compared to light element abundance measurements in CEMP stars (primarily CEMP-s stars, which are rich in $s$-processes elements and likely to have formed by mass transfer from an AGB star), focusing on the elements Li, F, Na and Mg. None of the elements is able to provide a conclusive picture of the extent of mixing of accreted material. We confirm that lithium can only be preserved if little mixing takes place. The bulk of the sodium observations suggest that accreted material is effectively mixed but there are also several highly Na and Mg-rich objects that can only be explained if the accreted material is unmixed. We suggest that the available sodium data may hint that extra mixing is taking place on the giant branch, though we caution that the data is sparse.Comment: Accepted for publication in MNRAS. 9 figures, 1 tabl