Since the mid-1980s, both Shanghai and Hong Kong have implemented health insurance reform to contain healthcare costs. But the reform result in these two places represents polar extremes. While Shanghai witnessed a revolution in healthcare financing in 2000, Hong Kong remains status quo on healthcare financing. Using the theory of historical institutionalism, this study examines how the complex interplay of forces affects health insurance reform implementation in these two places. It finds that Shanghai succeeded in implementing health insurance reform because of contextual influences, ideological shift, policy feedback, the authoritative political institutions, the dominance of key bureaucratic stakeholders in health insurance reform process, the endorsement of new ideas, and the decentralization power given to local governments. On the other hand, it finds that Hong Kong failed to implement any health insurance reforms in 1993 because of a more democratic political system, policy feedback, the persistence of old ideas, and a robust economy. Besides, it finds that the government failed to implement healthcare financing reforms in 1999 and 2000 because of a disjointed political system, difficult economic circumstances, the new idea lacking public acceptance, policy feedback, and the institutionalization of old ideas.
Drawing on a set of financial and budget specific indicators, the paper examines the financial activities of local authorities, aiming at diagnosing local public financial management. In the context of the increasing decentralization of public finance, local authorities must demonstrate the ability to manage local resources as efficiently as possible, adopting decisions (including financial ones) to respond promptly to citizen needs. For this reason, we set out to present an analysis model aimed at accustoming local decision-makers with the specific tools and methods and assisting them in gaining awareness of the benefits of such analyses. Empirical research shows that local authorities, due to the low income generation capacity, face a shortage of own resources, creating dependency on the state budget. Moreover, it has been demonstrated that that lack of resources limits both the investment capacity and the decision-making autonomy of local authorities in prioritizing spending. The analysis conducted in terms of performance indicators has revealed low level of local government involvement in stimulating economic activity in the community under examination.
The healthcare industry may be the largest and most expensive endeavor of the developed world, with the United States at the top of the list of per capita expenditure. Clearly, as indicated by the intense (and continuing) debate over the Affordable Care Act, the issues of the healthcare industry are of extreme interest to the public and policy makers.The biggest problems in the healthcare industry are about how to achieve its fundamental goalsâhow to provide adequate and equitable care to the entire populace; how to guarantee equitable access to all; how to achieve optimal population health; how to ensure efficacy, quality, and safety of patient care; how to provide choice of provider and hospital; and, most importantly, how to pay for all of these goals and how to obtain political agreement of the populace to make it happen.Fortunately, this monograph will address primarily issues of quality and safety, and will largely ignore these other very large and thorny issues. Some of the ideas in this chapter have been addressed in part by the author in prior journal publications.12From a safety standpoint, it is now well recognized that there is a significant incidence of harming patients in the course of trying to diagnose and treat them.3Many such events are known to be preventable. The incidence of minor problems is very high, but even serious events have been found in approximately 1% of all hospitalizations. It is often said that many of these adverse events are irrelevant because the patients they occur in are already very ill, and hence might well have suffered negative outcomes anyway. However, I contend that no patient âsigns up for bad care,â so we should still be very concerned about such events even when they do not, in the final analysis, actually affect the final outcome. The next time, maybe they will.In addition, it is likely that many errors that occur, even serious errors, are hidden. Some are not apparent because the patient is very ill, so only detailed investigation or analysis can disclose an error. In other cases, errors can be hidden simply by failing to inform anyone of them and waiting to see what happens. Moreover, healthcare does not have the robust incident or accident investigation processes that are routine in transportation (e.g., National Transportation Safety Board). Most investigationsâin the infrequent occasions that they occurâare conducted only at the local level and with varying degrees of sophistication and alacrity.Parts of healthcare (such as anesthesia and surgery) and nuclear power production are but two examples of activities of âhigh intrinsic hazardâ (aviation is a well-known third). The hazard in these activities is inherentâit can be managed and controlledâbut the hazard cannot be eliminated. Yet, the management of hazard in nuclear power and aviation has become so good that it is accepted that adverse events are not ânormal.âNuclear reactors should not unexpectedly interrupt power production, and they should never harm workers or the public, melt down, or explode. Airplanes are not supposed to crashâever. In these arenas when one of these things happens, we know that something went horribly wrong. Yet, human beings are inherently prone to catastrophic internal failures that result in serious disability or death. Thus, adverse outcomesânot necessarily due to errors or poor careâare very common in healthcare. All of us are going to die, and most of us will die in close proximity to healthcare. It is difficult to sort out which events are the ordinary ânatural historyâ of disease and which are due to suboptimal care. This makes efforts at measuring safety outcomes particularly difficult in healthcare.All of the high intrinsic hazard industries share the fact that they are so critical to human welfare that we cannot just shut them all down while we solve all of their problems. Certainly, we can't stop performing healthcare activities just because they are imperfectâthe ravages of disease are worse. While a single nuclear reactor can be shut down whenever necessary, and a flight can be cancelled or delayed, it is sometimes impossible (and possibly unethical) to refrain from or abort an emergency medical procedure due to a significant safety risk when the patient's underlying disease processes will otherwise quickly cause serious harm or death.Decisions on a larger scale are more complicated. While it is in principle possible to abandon the use of nuclear power in some countries, this can only be done temporarily or it must be phased out over a very long period of time. Access to abundant electrical power is the lifeblood of modern societies. Similarly, the dislocations caused by even short stoppages of air travel by the 9/11 terrorist event or the Icelandic volcano's ash cloud demonstrated that air travel also cannot be stopped for long. On the other hand, in healthcare, the introduction of new, potentially lifesaving drugs and devices can be delayed pending proof that they are safe and effective.The calculus of such decisions may vary from country to country, although many aspects of healthcare (and nuclear power production) are similar everywhere. In healthcare, the practices of physicians stem originally from the roots of the âautonomous healerâ who used individual, often idiosyncratic, knowledge and âskillâ to diagnose and treat ailments. There were few curative or invasive therapies. While administering potions to, cupping, and bleeding patients didn't usually help them very much, and might have hastened their demise, they were not generally powerful enough to directly cause serious harm or death. Hospitals were originally organized more as âguild workshopsâ 4 wherein the members of the physician's guild could independently ply their trade.Now, in the early 21st century, some things have changed drastically while others have not. We have many more diagnostic and treatment interventions that can often cure. Many are very powerful and can themselves directly, and quite quickly, cause serious harm or death. I like to say that there is a high potential lethality per square meter in settings like the operating room, intensive care unit, emergency room, or chemotherapy administration unit. Wielding such interventions requires very complex care coordinated across many individuals and many work units.Since the latter half of the 20th century, it has become possible to compare many patient outcomes in response to diagnosis or treatment, a process that is still unfinished. Despite all of this change, the structure of the hospital, for example, has not changed much in hundreds of years, retaining many elements of the guild workshop. Even where an institution is the employer of physicians, the amount of autonomy of practice given to physicians is enormous, despite the grumblings of how medicine is dictated by the rules and regulations of payers and other bodies. The system also is structured around assumptions that the individual skill of the professionals will be uniform, solid, and unvarying over time, which of course is impossible to guarantee.Even the division of labor is old. I conjecture that if healthcare were to be developed now, from scratch, we would not have job types of âdoctor,â ânurse,â âpharmacist,â and ârespiratory therapist,â to name only a few. We would have many other job types and a vastly different organizational and work structureâhopefully based on a more rational assessment of how best, and how safely, to achieve the goals of the work in the first place.A fundamental difference in healthcare versus other industries is that âweâ do not design or construct the units we work on: human beingsânor are we given an instruction manual for them. We do not understand a great deal of how the human body works, how it fails, or why and how it gets sick or recovers from illness. Yes, great strides have been made and more discoveries are happening every day, but we are mostly working empirically by trial and error.In my own field of anesthesia, we do not know many of the fundamental mechanisms by which our drugs can render patients unconscious, unaware, resistant to pain, immobile, and (fortunately) unable to recall what has transpired during surgery. Yet, by trial and error, we have worked out the methods to do these thingsâwhich clearly evolution never really intended for human beingsâon a regular basis with low, but not low enough, rates of serious problems.In healthcare, the public is very concerned with personal and intimate aspects of the work, and such individual, societal, and ethical issues are commonplace. They also care very deeply about choosing and seeing âtheirâ doctor. This is not the case for other industries where the public doesn't care specifically who exactly is doing the work (pilots and nuclear power plant operators interact with the public minimally, if at all). However, for nuclear power, the public has great concerns over the long-term impact of accidents, and also a hard to grasp âdreadâ factor of radiation that does not come into play in healthcare.56Organizationally, the nuclear power industry and healthcare are very different. There are just over 100 nuclear power reactors in the United States, owned and operated by 30â40 firms and under significant scrutiny by the federal regulator, the U.S. Nuclear Regulatory Commission (NRC).Healthcare is a vastly more decentralized and massive undertaking. There are 4,000â 6,000 hospitals, owned by 1,000â2,000 firms. There are roughly the same number of stand-alone surgicenters. There are more than 200,000 physician offices. More than 20 million surgical operations with anesthesia are performed, just under one billion doctor visits occur, and about three billion prescriptions are written every year in the United States. Yet, there is no federal regulatory agency of the practice of healthcare. That comes under the jurisdictions of the 50 states and the federal health systems (e.g., Department of Defense, Department of Veterans Affairs, and the Indian Health Service).The federal U.S. Food and Drug Administration regulates the approval and sale of drugs and devices. The federal Centers for Medicare & Medicaid Services (CMS) controls the criteria for federal payment for medical services. CMS may act as an indirect regulator of practiceâif you won't get paid for it, you probably won't do itâand there are other indirect regulators by accreditation (e.g., The Joint Commission) or by voluntary participation (e.g., Institute for Healthcare Improvement and the Leapfrog Group). However, indirect regulation is generally not comparable to direct regulation, as in the NRC's direct oversight of nuclear power, or the Federal Aviation Administration's direct oversight of aviation.Of note, in aviation and nuclear power, the firms themselves (individual airlines or individual power utility companies) impose strong safety control over the day-to-day work of personnel, often over and above the requirements of the regulator. This is only partially true for healthcare. The work of nurses, pharmacists, and allied health personnel comes under the direct purview of the employing institution, although the degree to which actual practices at the front line reflect the stated goals or policies of the institution varies greatly.The practices of physicians have less direct oversight by the firm; the majority of physicians are independent (fee-for-service, not salaried) members of the hospital's medical staff. As such, though not under direct line authority of the hospital, they must apply for clinical privileges and their actions can be scrutinized by the institution. Other influences on physician practices come from specialty board certification and professional society practice guidelines.However, when guidelines are well articulated, strongly evidence based, and widely agreed upon by the medical community, it typically takes a decade until these practices are consistently adopted and executed. Regardless of whether physicians are actual employees of the hospital or are independent medical staff members, in practice they have nearly unlimited discretion as to how they manage individual patients. Local standardized operating procedures are occasionally imposed, but even then their authority and compliance may be minimal, especially without specific incentives for compliance or disincentives for noncompliance.In fact, all of the hazardous industries suffer from a phenomenon in which what is articulated for safety on paper does not always correspond to the reality at the front line or even to a plausible reality that could be implemented at the front line. One aspect of this has been described by the sociologist Lee Clarke as âfantasy documents,â such as policies, procedures, or plans that are created to satisfy a regulatory, internal, or public relations need, but are known by most participants to be infeasible. They âsound goodâ and make people feel better, but it is widely knownâat least by frontline staffâthat they cannot really work as described.78One factor about the aftermath of accidents that affects other industries in a profound way that doesn't happen in healthcare is that a severe accident in nuclear power, in oil refining, or even in aviation, can seriously harm the âmeans of production.â That is, not only may the accident hurt workers or the public, it also takes out of service the facilities (power plants, refineries, or airplanes) that are used to do the work. Even ignoring cleanup or repair costs (if relevant), this means that there is a huge financial and operational loss from the lost means of production.As indicated above, for nuclear power, this can expand all of the way to long-term plans to abandon this method of generating electricity. None of these effects is seen in healthcare. If we harm a patient in the operating room, that may be very sad, may generate litigation, and may (rarely) garner bad publicity for the hospital, but we just âsend for the next patient.âI cynically suggest that if the aftermath of medical errors or preventably suboptimal care events in an OR, ICU room, or emergency department bay would be to take that room out of service for days or months, that would generate a much more aggressive response for improvement by the healthcare institution than we currently see.It is true that healthcare cannot strive for the same level of standardization within a facility, or especially between facilities having the same basic technology, as is achieved in nuclear power or the aviation industry. Human beings are not reactors or airplanes and diseases are not understood at fundamental levels, hence healthcare personnel need more flexibility to respond to unanticipated situations. However, as for many things in healthcare, the pendulum is currently too far to the side of insufficient standardization.On the equipment and procurement side, the decentralization and huge number of sites of care raise all sorts of issues. Unlike the 106 nuclear power plants of perhaps a few dozen designs, the hundreds of thousands of patient rooms, ORs, ICU bays, etc., in the 8,000 institutions each needs outfitting with various devices such as monitors and infusion pumps.Rather than being purchased as large, integrated, preconfigured units, such devices are often purchased one at a time, or, at best, in periodic bundles of hundreds. The combinatorics of all of the devices makes it impossible for vendors to test them in use all together. And, until fairly recently, there was little demand on vendorsâeither from regulators or the marketplaceâfor serious human factors testing of either prototypes or actual devices.The decision to purchase equipment is often made by small committees or single influential individuals based on idiosyncratic assessments of features. Purchase decisions are strongly affected by the purchase cost of the equipment and disposable supplies, and only rarely by total life cycle or systems cost. One area where both nuclear power and healthcare can benefit is to achieve and maintain a high degree of user-centered human factors testing of concepts, prototypes, and actual equipment during the design, premarketing, marketing, and postmarketing phases of product life.Issues of design are compounded in healthcare by the current variability in the preparation and training of personnel on the use of the equipment, even that which is life critical. Nursing and allied health disciplines generally have more structured mechanisms for providing training to personnel before they use advanced equipment via âin-servicesâ and checkoffs of competency.Even so, experience suggests that such checkoffs can be âfantasy activitiesââshowing that immediately after training, and in a quiet environment, a clinician can demonstrate performance of specific tasks doesn't necessarily correlate with skill with the device during actual use in challenging real-life conditions. Fortunately, most of the time, personnel do rapidly learn to use the essential aspects of equipment in their routine bedside activities.However, problems may arise especially for devices that are used only rarely (e.g., defibrillators), in situations requiring the use of advanced and complex device features, or when it is necessary to deal with unexpected glitches or faults (e.g., when something isn't hooked up quite right or the wrong button is accidentally pressed) in a stressful in physicians have been more resistant to to training, which is rarely made Thus, it is not for a physician to a device a anesthesia in patient having never or seen or used the healthcare, there is like the in aviation, of how much experience has as an they cannot an they have been specifically and as on that of In nuclear power, each plant has a of the control room on so it is that plant operators would be to control the reactor and systems if they are not with the this suggests that perhaps healthcare nuclear power have the optimal structure for In healthcare, it is and with little devices and systems are In nuclear power, there is strong control and little risk of by but at the cost of extreme and to especially in safety critical in so many there may be a in the Clearly, to its and physician autonomy and control by firms or but has to up to its for very high Nuclear power has an safety at least in the United States, but is, to a in its not of and other the two in many there are many of where of and may each industry to a that is more and at cost to the
Open access
Patient Safety and Medication Errors
Occupational Health and Safety Research
Health Systems, Economic Evaluations, Quality of Life
Dubravka Jurlina AlibegoviÄ, SunÄana SlijepÄeviÄ, Ćœeljka Kordej-De Villa
The decentralization process started in 2001 by broadening the responsibilities of local self-government units and changing the sources of financing public functions. In spite of these steps toward decentralization, today Croatia exhibits low level of fiscal decentralization compared to EU and SEE countries. In the paper we show that large differences in fiscal capacity between local government units and their large reliance on received grants represent one of the main barriers for further decentralization process. Based on the analysis of the results of conducted interviews with representatives of local and regional units, we present recommendations for further process of decentralization.
Muhammad Asim Tufail, Abu Hassan Abu Bakar, Wiwied Virgiyanti, Faisal Manzoor Arain
Technological development in the information and communication technologies (ICT) sector is essential to attain sustainability in todayâs era. Cities have developed satellite towns at the periphery with hi-fidelity digital and physical infrastructure which converts a single cantered city into a multi cantered one. In case of Kuala Lumpur Metropolitan Area (KLMA) the shift of civic services to Putrajaya and development of Multimedia Super Corridor (MSC) which offers incentives to local and foreign companies to develop a super block of research and development based economic sector. This development spearheaded the Malaysian Vision 2020 of knowledge based economy and society and has become an attraction to the business community across Malaysia. The purpose of this paper is to discuss the key factors that have attracted the companies to physically move from KLMA to MSC. To achieve the study objectives, a questionnaire survey and interviews were carried out to collect pertinent information from companies focusing on businesses in finance, insurance and real-estate. The data collected was analyzed to identify the ranking of variables of Bill of Guarantees offered in MSC policy. The study findings suggest that in addition to good infrastructure and good working environment, the tax exemption offered by the government has been the driving force for companies to decentralize towards MSC. The results suggest that the better infrastructure, connectivity, low taxes, low telecommunication tariffs, and land cost were considered as the most important factors for decentralization of ICT companies in Malaysia. The other factors that were highlighted in this study include low cost of doing business, and competitive conditions for attracting companies to avail MSC status. The study also presents the initial hindrances faced by the ICT companies i.e., accessibility issue for city clients and workers, high rental rates of the property and slow development of supportive public amenities in MSC
Cayrel.et.al at SAC 2010 proposed a zero-knowledge identification scheme based on syndrome decoding of q-ary codes. It is a 5-pass scheme with soundness error q/2(q-1). We propose an alternative to this scheme by generalizing (binary) Stern zero-knowledge identification from CRYPTO 1993 directly to q-ary setting. Our proposal is a 3-pass scheme with soundness error 2/3. We show that it is superior to Cayrel et al scheme in terms of communication cost for the case q = {3, 4}. A possible application for q-ary code-based identification schemes with small q is a proof of plaintext knowledge for code-based public key encryption.
Norfariza Mohd Radzi, Muhammad Faizal A. Ghani, Saedah Siraj, Mojgan Afshari
This article presents findings on the essential strategies required at the school site and the relevant people responsible for the effective implementation of school-based financial management in Malaysia. Many lessons have been learned since more than a decade of the school-based financial management reform in Malaysia through the establishment of school as Responsibility Centre or Pusat Tanggungjawab (PTj). The government of Malaysia has allocated an enormous amount of money for the education sector during last the few decades to ensure the highest quality of education for Malaysian society. Therefore school finance has to be managed strategically to confirm the best educational outcome through effective resource allocation. This study employed the qualitative approach using the interview method with ten selected principals heading schools with financial autonomy in Malaysia. The findings revealed a few essential strategies that need to be focused by schools both at individual level and school level in order to successfully manage school finances. The collaboration and mutual effort from all stakeholders are expected to bring transformation toward effective school based financial management in Malaysia.. Keywords: school-based, financial management, effective,
The paper deals with comparison of fiscal decentralization systems in EU-27 according to selected quantitative criteria and certain European Charter of Local Self-Government principles. The results of comparative analysis show that a higher number of lower levels of government usually indicate a greater share of local finance within the total public finance, however, this finding does not confirm the inverse link. Even though the structure of expenditures in EU-27 countries is quite similar, the shares of funds for the implementation of individual tasks and competencies differ significantly from country to country. On average, the countries allocate most funds to education, social security, healthcare, administration and political systems, with only a quarter of the countries recording the same or higher amounts of revenues than expenditures. Most of the countries still cover the existing deficit either through transfers from the central to lower levels of government or through equalisation schemes or borrowing, which otherwise represents a departure from one of the basic principles of the Charter, which stipulates that financial resources must be commensurate with the responsibilities of local self-government.
This paper concerns the open source software project Bitcoin, which is often described as virtual cash. The paper investigates what âvirtualâ signifies when applied to âcashâ and in turn what âvirtual cashâ says about Bitcoin. Bitcoin is the latest cryptographic effort to create digital cash-like tokens, where Bitcoinâs designer Nakamoto argues that users now no longer have to trust a third party, traditionally the bank. Paradoxically, for Bitcoin it is key that nodes in the network agree on the status of the shared block chain database. Trust remains to be established, albeit in a different manner. Power is not destroyed, but transferred from banks to Bitcoinâs protocol. The paper concludes that âvirtualâ refers to Bitcoinâs model of how cash appears to function in everyday exchange, allowing user privacy. Bitcoin does not model another aspect of cash, its function as a credential referring to debt. Bitcoin discontinues the concept of debt.
The Whitbread Investment Company (WIC), commonly referred to as the Whitbread Umbrella, was an investment trust comprising minority shareholdings in a large array of regional and family brewers that was established in 1956. It was a listed company quoted on the UK stock exchange but was majority owned by the Whitbread group and members of the Whitbread family; the chairman of Whitbread was also a director of WIC. The structure survived in this form as a quasi-independent entity until 1994, when, under increasing pressure from institutional shareholders, the Whitbread group was forced to end its own two-tier voting structure as well as acquire, then subsequently divest, the minority shareholdings of WIC. As an essentially bid-proof trust WIC served to maintain the independence of not just the many regional brewers it had invested in - at least for a time - but also the wider Whitbread business. As explained in the 1989 anti-trust inquiry into the UK brewing industry, the backdrop to the establishing of WIC was the post-World War II fledgling market for corporate control emanating from the changes in legislation brought about by the Companies Acts of 1947 and 1948. Fearing that their independence was at risk from hostile approaches from early financial entrepreneurs, a group of family-managed and property-rich regional brewer-retailers sought the help of the larger patriarchal Whitbread, under the auspices of the influential Colonel W.H. Whitbread. Whitbread obliged with equity investment in return for formalised trading agreements and in some cases an invitation for a Whitbread director to join the board of the regional brewer. As the 1950s progressed, Whitbread expanded the number of such relationships and ring-fenced them in the WIC structure. In addition, the relationship between WIC, Whitbread and the Whitbread family was strengthened by WIC accepting Whitbread âAâ (ordinary) shares in lieu of payment for Whitbreadâs acquisition of control of some of WICâs investments and the purchase of high voting âBâ shares (twenty times the vote of an âAâ share) from Whitbread family members when they became available. By the time of the âmerger waveâ of 1968-72 that saw the entry of influential property finance entrepreneur Maxwell Joseph into the Beerage through the hostile bid for southern neighbour Watney Mann, Whitbread, via the agency of WIC, had brought under full ownership and control the majority of the original 20 or so regional brewery investments. It had become one of the largest national brewer-retailers through sequential acquisition without recourse to the capital markets. While the umbrella structure did not of itself prevent third party approaches to one of the regional firms (WIC considered offers on longer term merits alone, and in the case of the 1992 hostile bid for Morland from rival Greene King, it sold its 28.5 per cent stake to the predator) the complexity of the arrangement and the involvement of the larger Whitbread were seen as an effective defence to a hostile bid. WIC was a firm-sponsored solution to a perceived issue arising in the post-world war II period, specifically changes in company law that created a market for corporate control. That this might not have acted in the best interests of the wider brewing industry was summed up in a Campaign for Real Ale poster: âa fine idea in principle, but as the murdered diplomat Gregory Markov discovered, an Umbrella can be a pretty nasty weapon in the wrong handsâ (CAMRA poster, 1988). References: Bower, J. and Cox, H. (2012) âRegulatory capture and special interest pleading: how Scottish & Newcastle became the UKâs largest brewerâ, Business History Review, 86 (Spring): 43-68. Franks, J. and Mayer, C. (1996) âHostile takeovers in the UK and the correction of managerial failureâ, Journal of Financial Economics, 40 (1): 163-181. Gourvish, T.R. and Wilson, R.G. (1994) âThe British Brewing Industry 1830-1980â, Cambridge, UK Hannah, L. (1974) âTakeover bids in Britain before 1950: an exercise in business âpre-historyâ, Business History, 16 (1): 65-77.
Although academic and practical interest in non-fungible tokens (NFTs) has continuously increased over the last few years, there is still a need to better understand their social acceptability. The aim of the study was to explore the double edge of NFT legitimacy for NFTs by unveiling the role of sustainability and by adopting technology legitimacy and the field of sustainability transition studies as a theoretical lens. Specifically, this research investigates the role of sustainability in securing and maintaining technology legitimacy within NFT projects. We interviewed 12 experts through exploratory qualitative research. The findings highlight three main ways in which sustainability participates in the legitimation of NFT projects. While sustainability can be inherent in the NFT project itself, this legitimation can also be derived from the perceived sustainability of the NFT technology or be part of innovative business models. Theoretical contributions and managerial implications are then discussed. JEL CODES: O33, O35, O50
Bit commitment is a fundamental cryptographic task that guarantees a secure commitment between two mutually mistrustful parties and is a building block for many cryptographic primitives, including coin tossing, zero-knowledge proofs, oblivious transfer and secure two-party computation. Unconditionally secure bit commitment was thought to be impossible until recent theoretical protocols that combine quantum mechanics and relativity were shown to elude previous impossibility proofs. Here we implement such a bit commitment protocol. In the experiment, the committer performs quantum measurements using two quantum key distribution systems and the results are transmitted via free-space optical communication to two agents separated with more than 20 km. The security of the protocol relies on the properties of quantum information and relativity theory. We show that, in each run of the experiment, a bit is successfully committed with less than 5.68*10^-2 cheating probability. Our result demonstrates unconditionally secure bit commitment and the experimental feasibility of relativistic quantum communication.
Although academic and practical interest in non-fungible tokens (NFTs) has continuously increased over the last few years, there is still a need to better understand their social acceptability. The aim of the study was to explore the double edge of NFT legitimacy for NFTs by unveiling the role of sustainability and by adopting technology legitimacy and the field of sustainability transition studies as a theoretical lens. Specifically, this research investigates the role of sustainability in securing and maintaining technology legitimacy within NFT projects. We interviewed 12 experts through exploratory qualitative research. The findings highlight three main ways in which sustainability participates in the legitimation of NFT projects. While sustainability can be inherent in the NFT project itself, this legitimation can also be derived from the perceived sustainability of the NFT technology or be part of innovative business models. Theoretical contributions and managerial implications are then discussed. JEL CODES: O33, O35, O50
This thesis examines motives of demand for digital currency Bitcoin. We estimate transaction and speculative motives of Bitcoin users and their impact on the emerging digital currency. We analyze Bitcoin data and argue that external Bitcoin trading is mostly influenced by speculative motive. Speculative trade volume on average appreciates Bitcoin exchange rate. However internal Bitcoin transactions are driven mostly by transaction motive and are largely independent on Bitcoin trading. Speculative and non-speculative motived users thus coexist in separate circuits, interacting mostly indirectly through exchange rate and acceptability of Bitcoin. In the last part we argue that quantity theory of money is well applicable on transaction-based data, which Bitcoin provides, and use it to estimate money velocity and output index. We show that growth of Bitcoin accounts brings significant network effect and along with number of transactions largely explains growth of output index. Author: Martin Janota Thesis name: Digital currencies: Analysis of Bitcoin demand
The main aim of this bachelor's thesis is indebtedness of municipal budgets that is caused especially by funding of investments by bank loans. The first part is theoretical and is focused on position of municipalities in state hierarchy which is in direct connection with fiscal decentralization and budget. There is information about another possibility of fund-ing with emphasis on bank loans as the most widespread way of financing, too. Neverthe-less, it is necessary to mention credit risk and rating of economy situation of applicant. Finally, there are few notes about regulation of municipal debt in the Czech Republic by Ministry of Finance and calculation of indicators of indebtedness in financial analysis. The theoretical knowledge is used in the analytical part in case of municipality Horni Lidec. I have made a short financial analysis with focus on indebtedness and chose the best option for funding development of the municipality.
Housing finance is both the servant and the master of the housing process. The finance available fits into the general policy framework in that it enables the construction of housing within the wider supply context current at the time. It also drives the process: reductions in finance affect the scale of supply and allocation among groups supplying and demanding housing. In times when centralized control is politically dominant, finance is likely to be directed at governments and their agencies. Decentralization directs finance to smaller units, concentrating more on local authorities than on central governments. In times when nongovernmental organizations (NGOs) are trusted above governments, shelter finance will be channelled through them. The same occurs when citizen groups gain power and respect.
Delywn L. Harnisch, Timothy C. Guetterman, Olga Samofalova, Yelena Kussis
As the last Soviet republic to become an independent nation, Kazakhstan has worked diligently to transform and develop its educational system including systemic changes related to decentralization, financing changes, and the shift to a credit system. A professional health sciences education workshop delivered in Kazakhstan exemplifies progressive educational approaches. Attendees were educators from universities across Kazakhstan. The workshop was the product of collaboration between educators in the United States and Kazakhstan. Team-based learning was both a pedagogic method and topic of the workshop. Technology played a central role in the workshop, as it was integral to workshop development, collaboration, and evaluation. Furthermore, technology became a key content area of the workshop, as the educators presented advances in technology and specific tools to aid in the education of future medical professionals in Kazakhstan. In the months following the workshop, attendees embraced the challenge to take what they have learned back to their own universities by telling their stories. Using the collaborative learning approach and technological tools from the workshop, the attendeesâ spirit of sharing reflects the dynamic development of education in Kazakhstan in the post-Soviet era.
Michele Gragnolati, Magnus Lindelöw, Bernard F. Couttolenc
Discusses the extent to which reforms have transformed the health system, focusing on the expansion and reorganization of service delivery, financing of health services, and governance and accountability arrangements of the Brazilian Unified Health System (Sistema Ănico de SaĂșde, SUS). The reforms envisaged a fundamental transformation, with universality, equity, integration, decentralization, and participation as key principles. Significant progress has been made, in that the capacity to deliver services has expanded, regional disparities in the availability of services have been reduced, primary health care has been strengthened, most of the responsibilities for delivering services have been decentralized to municipalities, government health expenditures have increased, and various institutional mechanisms and innovations have been introduced to enhance coordination, participation, and efficiency. The SUS reforms also triggered several initiatives aimed at increasing and stabilizing public financing for health. Important challenges for the future include intergovernmental finance and coordination and the evaluation and consolidation of models for contracting, integrating, and delivering health services.