Showing papers on "Directive published in 2013"

End-of-Life Care Issues: A Personal, Economic, Public Policy, and Public Health Crisis

Abstract: Advance directive documents are free, legal, and readily available, yet too few Americans have completed one. Initiating discussions about death is challenging, but progress in medical technology, which leads to increasingly complex medical care choices, makes this imperative. Advance directives help manage decision-making during medical crises and end-of-life care. They allow personalized care according to individual values and a likely reduction in end-of-life health care costs. We argue that advance directives should be part of the public health policy agenda and health reform.

Compiling a High-level Directive-Based Programming Model for GPGPUs

Abstract: OpenACC is an emerging directive-based programming model for programming accelerators that typically enable non-expert programmers to achieve portable and productive performance of their applications. In this paper, we present the research and development challenges, and our solutions to create an open-source OpenACC compiler in a main stream compiler framework (OpenUH of a branch of Open64). We discuss in details our loop mapping techniques, i.e. how to distribute loop iterations over the GPGPU’s threading architectures, as well as their impacts on performance. The runtime support of this programming model are also presented. The compiler was evaluated with several commonly used benchmarks, and delivered similar performance to those obtained using a commercial compiler. We hope this implementation to serve as compiler infrastructure for researchers to explore advanced compiler techniques, to extend OpenACC to other programming languages, or to build performance tools used with OpenACC programs.

Addressing resource efficiency through the Ecodesign Directive: a review of opportunities and barriers

Abstract: The European Union has initiated a number of initiatives to improve resource efficiency in Europe. The Ecodesign Directive is one of the policy instruments that could aid the transition towards a more resource efficient economy. This paper examines the potential benefits and disadvantages in applying the Directive for this purpose, and reflects on the potential to apply certain types of standards. The research builds on literature studies and interviews. A main conclusion is that some types of legal requirements are more feasible than others, and that the type of product and user patterns are of high importance when legal requirements are assessed.

When Previously Expressed Wishes Conflict with Best Interests

Abstract: Rising use of advance directives has made surrogate decision making both easier and harder. In many cases, these directives help guide decision making for patients who have lost decision-making capacity. In some cases, however, directives may conflict with what physicians or surrogates view as what is in the patient's best interest. These conflicts can place substantial emotional and moral burdens on physicians and surrogates, and there is little practical guidance for how to address them. We propose a 5-question framework for untangling the conflict between advance directives and best interests of a patient with a surrogate decision maker: (1) Is the clinical situation an emergency? (2) In view of the patient's values and goals, how likely is it that the benefits of the intervention will outweigh the burdens? (3) How well does the advance directive fit the situation at hand? (4) How much leeway did the patient provide the surrogate for overriding the advance directive? (5) How well does the surrogate represent the patient's best interests? We use 2 clinical cases with contrasting outcomes to demonstrate how this framework can help resolve common dilemmas.

Advance medical directives: a proposed new approach and terminology from an Islamic perspective.

Abstract: Advance directives are specific competent consumers' wishes about future medical plans in the event that they become incompetent. Awareness of a patient's autonomy particularly, in relation to their right to refuse or withdraw treatment, a right for the patient to die from natural causes and interest in end of life issues were among the main reasons for developing and legalizing advance medical directives in developed countries. However, in many circumstances cultural and religious aspects are among many factors that can hamper implementation of advance directives. Islam and Muslims in general have a good understanding of death and dying. Islam allows the withholding or withdrawal of treatments in some cases where the intervention is considered futile. However, there is lack of literature and debate about such issues from an Islamic point of view. This article provides the Islamic perspective with regards to advance medical directive with the hope that it will generate more thoughts and evoke further discussion on this important topic.

A population-based study on advance directive completion and completion intention among citizens of the western Canadian province of Alberta.

Abstract: Determining what proportion of the public has completed an advance directive and which population subgroups complete or do not complete such a directive is crucially important for planning purposes. Our research objective was to examine and compare advance directive completion, intention to complete, and noncompletion rates among citizens of one Canadian province. A telephone survey was conducted with 1,203 Albertans who met gender, age, and other requirements for a representative sample. When asked, "Do you have a living will or personal directive?" 43.6 percent reported having completed a directive and 42.1 percent indicated that they planned or intended to complete one. Completion rates increased with age. Widowed, self-employed, and retired people, and those who had lost a family member or friend and had other select end-of-life experiences and viewpoints were significantly more likely to have completed one. Although older people more often had an advance directive, personal life-and-death experiences should be recognized as major influences on directive completion.

Advance directives in the context of end-of-life palliative care.

Abstract: Purpose of reviewTo review the definition of advanced directive, understand the implications for the patient, family and healthcare team, and address the obstacles involved in the implementation.Recent findingsAdvanced directives propose a model of healthcare based on patient preferences. Although t

The economic analysis in the implementation of the Water-Framework Directive in Spain

Abstract: One of the most innovative elements of the Water-Framework Directive (WFD) is the important role that economic analysis is assigned in achieving its environmental objectives. In Spain, a great effort has been put forth by river basin agencies to diagnose the current state of water bodies and to implement the economic tools and principles required by the Directive. However, there have been a number of shortcomings in the way the economic analysis was designed and applied (as well as a significant delay in meeting the WFD's deadlines). The objective of this paper is to critically review the implementation of the economics of the WFD in Spain and to make suggestions on how to deal with the problems that have been encountered. Some of the more important shortcomings are that the characterization of water uses is mostly descriptive and lacks prospective analysis; that analysis of the potential for costs recovery of water services has incorrectly assumed that the financial costs of water provision are completel...

A Survey of Stakeholder Knowledge, Experience, and Opinions of Advance Directives for Mental Health in Virginia

Abstract: An innovative Virginia health care law enables competent adults with serious mental illness to plan for treatment during incapacitating crises using an integrated advance directive with no legal distinction between psychiatric or other causes of decisional incapacity. This article reports results of a survey of 460 individuals in five stakeholder groups during the initial period of the law’s implementation. All respondents held favorable views of advance directives for mental health care. Identified barriers to completing and using advance directives varied by group. We conclude that relevant stakeholders support implementation of advance directives for mental health, but level of baseline knowledge and perception of barriers vary. A multi-pronged approach will be needed to achieve successful implementation of advance directives for mental health.

Adapting environmental conservation legislation for an enlarged European Union: experience from the Habitats Directive

Abstract: The European Union's (EU's) Habitats Directive includes annexes listing the habitats and species requiring protection. As new countries join the EU these lists need to be amended to remain pertinent. In 2004 and 2007, 12 countries, mostly in central Europe, joined the EU and were asked to propose native species or habitats that required protection; this formed an initial base for negotiations with the European Commission in consultation with the existing member states and with scientific support from the European Topic Centre on Biological Diversity. The 12 countries made 831 proposals, resulting in the addition of 191 species and 33 habitats, and geographical exemptions for eight species. Although the Directive provided definitions, these needed to be supplemented with additional criteria to permit assessments of the proposals. The process involved many actors at both European and national level. This illustrates the development of biodiversity governance and provides potential lessons for future activities, including the need for scientific guidance and the importance of involving all relevant actors.

The leadership style and the productiveness of employees in the banking sector in Slovakia

Abstract: The main goal of the article was to prove a relationship between applied leadership style of branch managers and productiveness of bank sales clerks and room for their productiveness im- provement applicable in the banking sector in Slovakia. One part of the objective was to examine the continuity between applied leadership style of branch managers and their time in control functions held. Dependencies between the individual productiveness of bank sales clerks and the level of their loyalty and satisfaction were investigated. Opinions of branch managers about the applicable leadership style and room for sales clerks' productiveness improvement were ex- amined through two questionnaire surveys (conducted in 2008 and 2012). The research results confirmed that the directive style of leadership is the mandatory style in the banking sector in Slovakia whereas the intensity of its implementation during the analysis period was increased. The research has also shown that there is a direct connection between the dominant style of leadership and room for improvement of sales clerks' productiveness, because the growth of the intensity of directive style in this case led to lower productiveness of the average bank sales clerks. Our assumption that the applied leadership style of bank employees depends on time working in managerial positions has not been confirmed. In comparison to long-term managers, branch managers who were working for rather short period in any managerial positions did not show any differences in their management priorities. The assumption that the employee satisfac- tion and loyalty significantly encourage individual employee productiveness was not confirmed in the research.

Free provision of services and cross-border labour recruitment

Abstract: This article identifies how the use of the European Union (EU) mobility rules, as formulated by the EU's Posting Directive, has been linked to the temporary provision of services in practice. It demonstrates how this linkage, legitimised by European Court rulings, undermines the Directive's original intent to provide rights-based regulation of labour mobility in the Union. In the assessment of posting practices, striking findings of two studies co-conducted by the author in 2003 and 2010 are discussed. In the first section, the origins of the Directive are described, followed by sections that contextualise the posting rules in the framework of the fundamental economic freedoms of EU Treaties, and discuss the problems related to implementation and enforcement. Based on the Directive's definition of posting, three issues of governance and practice are raised: (a) regulation of the employment relationship, (b) application of labour conditions and (c) respect for collective agreements. A final section offers ...

The Unintended Consequences of Ecological Modernization: Debt-Induced Reconfiguration of the Water Cycle in Barcelona

Abstract: In the context of the European debt crisis, neoliberal reforms question the legitimacy of the state in the direct provision of basic services. Water governance mirrors such issues. In Metropolitan Barcelona (northeast Spain) the water cycle is being redrawn with the leasing to private hands of the regional public bulk water supplier. The unbearable debt accumulated by the Catalan Water Agency is used as the discursive justification of the ‘inevitability’ of granting to private capital the control over the water cycle. We attempt to demonstrate that this debt is the result of large investments, required by European directives (Wastewater Directive, Drinking Water Directive, and European Water Framework Directive) to improve the quality of rivers and water bodies. These directives, combined with the restrictions imposed on budget deficits by the European Union and the inadequate regional financing model of water have put the Catalan Water Agency against the wall. The financial crisis, wreaking havoc in Spai...

I consent: An analysis of the Cookie Directive and its implications for UK behavioral advertising

Abstract: This paper assesses implications for the practical and theoretical understanding of consent in light of the coming into force of the European Cookie Directive (2009/136/EC). This Directive shifts behavioral advertising from being an opt-out practice to an opt-in one requiring consent. The aim of this paper is to assess conceptions of consent as detailed by the European Article 29 Data Protection Working Party, the UK government and the behavioral advertising industry. This is achieved through the application of philosophical understandings of consent generated in the first half of the paper that detail the ways in which these have been applied in health, an area that deals extensively with informed consent. The paper concludes by offering recommendations to behavioral advertisers on how best to implement opt-in consent policies so as to progress to ethically sound privacy practices.

Avoiding another directive: the unstable politics of European Union cross-border health care law.

Abstract: The European Union’s (EU) 2011 Directive on cross-border patient mobility codifies the right of any EU citizen to travel abroad for treatment and be reimbursed on the same terms as they would be at home. Governments hoped it would end the string of court cases that had reshaped EU health law but this article argues that it is likely to produce yet more judicial challenges. Patient mobility is an attractive idea with unclear definitions and divergent implementation. In many cases, providers, insurers and governments will not communicate and leave the patient with a bill – almost daring the patient to sue, and the courts to make more policy. Governments should try to prevent this by investing in coordination and alternative redress for patients who might otherwise sue.

Why come here if I can go there? Assessing the ‘Attractiveness’ of the EU’s Blue Card Directive for ‘Highly Qualified’ Immigrants. Paper on Liberty and Security in Europe No. 60, 14 October 2013

Abstract: This paper analyses the attractiveness of the EU’s Blue Card Directive – the flagship of the EU’s labour immigration policy – for so-called ‘highly qualified’ immigrant workers from outside the EU. For this purpose, the paper deconstructs the understanding of ‘attractiveness’ in the Blue Card Directive as shaped by the various EU decision-making actors during the legislative process. It is argued that the Blue Card Directive sets forth minimum standards providing for a common floor – not a common ceiling: the Directive did not, as originally envisaged by the European Commission, create one European highly skilled admission scheme. This raises questions regarding its concrete use. A critical focus is placed on the personal scope of the Blue Card Directive and the level of rights offered, and a first comparative perspective on the implementation of the Directive in five member states is provided.

Leadership lessons from the Chilean mine rescue

Abstract: Three years ago, when a cave-in at the San Jose mine in Chile trapped 33 men under 700,000 metric tons of rock, experts estimated the probability of getting them out alive at less than 1%. Yet, after spending a record 69 days underground, all 33 were hoisted up to safety. The inspiring story of their rescue is a case study in how to lead in situations where the stakes, risk, and uncertainty are incredibly high and time pressure is intense. Today executives often find themselves in similar straits. When they do, many feel torn. Should they be directive, taking charge and commanding action? Or should they be empowering, enabling innovation and experimentation? As the successful example of Andre Sougarret, the chief of the mine rescue operation, shows, the answer is yes--to both. The choice is a false dichotomy. Implementing this dual approach involves three key tasks. Each has directive and enabling components. The first task is envisioning, which requires instilling both realism and hope. The second task is enrolling, which means setting clear boundaries for who is on and off the team, but inviting in helpful collaborators. The third task is engaging--leading disciplined execution while encouraging innovation and experimentation. The authors of this article describe how Sougarret ably juggled all of these tasks, orchestrating the efforts of hundreds of people from different organizations, areas of expertise, and countries in an extraordinary mission that overcame impossible odds.

Modelos de transposición de las Directivas 2002/91/CE y 2010/31/UE “Energy Performance Building Directive” en los Estados miembros de la UE. Consecuencias e implicaciones

Abstract: The 2002/91/EC Directive (Energy Performance Building Directive – EPBD (1)), published by the European Commission and recast in the 2010/31/EU (2), requires European countries to meet certain minimum energy requirements in buildings and their systems. Each Member state is obliged to incorporate the Directive as national law(s), establishing the necessary conditions and procedures at a national level (3). In the present document a compilation of energy efficiency standards for buildings across Europe has been made, analyzing the consequences and implications of the different transposition models of the EPBD adopted by each country. Furthermore, the methodologies most widely used for determining the energy efficiency of buildings, legal gaps and the possibilities for improvement in areas such as professional accreditations or financial incentives are also described.

The Regulation of Water Services in the EU

Abstract: The European Commission’s proposal for a Directive on the award of concession contracts has sparked vigorous public debate and intense opposition. This Directive is controversial because of the nature of the policy it proposes and because the sectors involved are highly sensitive. This Forum examines the weaknesses of the Commission’s proposal and presents an overview of the current issues in water regulation and the provision of water services. The authors analyse the regulation of natural monopolies, water efficiency and upstream competition in the water industry.

The EU and Immigration Policies: Cracks in the Walls of Fortress Europe?

Abstract: 1. The Regulation of Immigration by the European Union: An Empirical Puzzle 2. Actor Preferences in EU Immigration Policies 3. Actor Interactions in EU Immigration Politics 4. Shifting Immigration Policies to the EU Level: Timing and Framing Policies 5. The Family Reunification Directive 6. The Long-Term Residents Directive 7. EU Directives for Students and Researchers from Third Countries 8. The Labour Migration Directive 9. Accounts, Prospects, and International Migration Governance

The law of unintended consequences

Abstract: The medical innovation bill being proposed by Lord Saatchi is laudable in its intentions.1 But the medical innovation bill runs the risk of further embedding the practice of defensive medicine by setting out even more legal criteria that could expand the scope of legally defined medical negligence. Furthermore, the distinction between clinical research with no direct benefit to patient and innovative treatment intended to benefit the patient is an artificial one. Hence, the laudable aims of medical innovation bill are likely to run foul of the EU clinical trials directive. The EU clinical trials directive, which initially set out with the commendable aims of promoting research and protecting patients, ended up stifling academically led, innovative, cutting edge research. The mountains of paperwork essential for demonstrating compliance with EU clinical trials directive choked off the seeds of innovation.2,3 The cancer researchers would be grateful if Lord Saatchi and peers could devote their energies to removing the yoke of EU directive on small, academically led, innovative studies.

Recent European Legislation on Management of Wastes in the Food Industry

Abstract: One of the main drivers for sustainable management of biowastes is a requirement under the EU Landfill Directive (99/31/EC) for diversion of biodegradable wastes from landfill because of their potential for greenhouse gas emissions. Exploiting the effectiveness of waste-management policies, various legal aspects of food industry wastes and examples of their application are described. Updates of biowaste management in the EU agenda as well as environmental management standards for the food industry are presented. This chapter discusses methods for implementation of the EU Council Directive on Integrated Pollution Prevention and Control (1996), selecting Best Available Technique candidates for the food and drink sector. Other EU documents related to food waste, which we address, are the Packaging Waste Directive (1994), the Animal By-products Directive (2000), and the Waste Framework Directive (2008).

The Difficulties of Regulating Markets and Risks in Europe through Notified Bodies

Abstract: Although scholars have described and commented on the European New Approach to standardisation principles, they have paid much less attention to the ways in which this innovative process and its follow-on, i.e. the Global Approach, have been implemented. In many cases, this comes through the day-to-day activity of a very specific population of European experts, the notified bodies. Notified bodies, whose role it is to certify that products, for a given sector, comply with the essential safety requirements set out in the corresponding directive, originate from the Member States, but also compete against each other within a European certification market. This article examines the technical and political difficulties encountered by the Commission and the Member States in ensuring both the independence and the competences of these certifiers. It describes and questions the organisational architecture devised in response to these problems.

Sustainable Public Procurement: Life-Cycle Costing in the New EU Directive Proposal

Abstract: The European Commission published its proposal for the new Public Procurement Directives,1 which, upon adoption, will have as effect the repelling of the current Public Sector Directives (Directives 2004/17/EC and 2004/18/EC)2 from 30 June 2014. The Commission’s stated objectives were twofold: improving the efficiency of procedures and allowing for greater strategic use of public procurement to further environmental, social and industrial/ innovation policies. One of the novelties of the proposal is a concept which did not exist in Directive 2004/18: That of life-cycle costing. The aim is to strongly encourage procurers to “think outside the (price) box” in the context of sustainable public procurement. In the last years, most of the EU Member States have already committed to the promotion of green public procurement (GPP) or sustainable public procurement (SPP).3 Studies show that many procuring entities in the EU include at least one green criterion among award criteria, while in Member States with a stronger record of sustainable purchasing, around half of the awards are made based on green criteria.4 Nonetheless, a certain degree of scepticism still lingers concerning both the legitimacy of using the award of public contracts to pursue sustainability-related objectives and its effective-