Le pouvoir de marché des entreprises a toujours été un sujet d’intérêt tant du point de vue du bien-être économique que de l’allocation des ressources. D’une part, le pouvoir de marché incite les entreprises à moins produire - réduisant le bien-être des consommateurs et d’autre part, la variation de la marge bénéficiaire entre les entreprises induit une friction sur l’allocation des intrants et diminue la productivité agrégée. Suite aux récents débats sur la concentration des parts de marché dans l’économie américaine par une minorité d’entreprises, la question du pouvoir de marché et ses implications ont été largement débattues. Cette thèse, divisée en trois chapitres, contribue à cette vaste littérature d’étude du pouvoir de marché de l’entreprise. Le premier chapitre examine les causes de la hausse des marges bénéficiaires aux États-Unis dans un environnement où les entreprises accumulent des actifs intangibles. En effet, au cours des quatre dernières décennies, l’économie américaine a connu une augmentation en moyenne des marges bénéficiaires par les entreprises et une augmen- tation de la concentration des parts de marché. Ces faits ont suscité des inquiétudes quant au pouvoir de marché détenu par certaines entreprises et à l’étendue de la concur- rence. Dans ce chapitre, nous proposons une nouvelle méthode d’agrégation des marges bénéficiaires des entreprises utilisant la distribution des parts de marché. Ensuite, nous documentons trois faits empiriques basés sur la distribution jointe des marges et des parts de marché des entreprises cotées en bourse. Premièrement, la hausse de la marge agrégée a été bien inferieure à celle suggerée par la moyenne. Deuxièmement, les plus grandes entreprises en termes de part de marché, appelées "superstars", ne possèdent pas les marges bénéficiaires les plus élevées et troisièmement, la hausse de la marge agrégée résulte principalement d’une réallocation des parts de marché, associée conjointement à une variation des marges des entreprises. Pour expliquer ces faits, nous proposons un modèle où les entreprises accumulent des actifs intangibles sous forme de base de clients le long de leur cycle de vie, en investissant une valeur fixe de leurs ventes. Une baisse dans la rentabilité des entreprises entrainent une réduction temporaire des marges, afin que ces dernières fixent des prix bas et attirent de nouveaux clients. Une hausse des investissements en base de clientèle profite aux entreprises ayant de fortes opportunités de croissance, leur permettant d’accroitre les parts de vente et d’augmenter davantage leur marge bénéficiaire. Ainsi, l’augmentation des investissements en base de clientèle au cours des quatre dernières décennies explique de moitié l’augmentation globale des marges bénéficiaires aux États-Unis. Le deuxième chapitre examine les implications d’une variation endogène des marges bénéficiaires sur la productivité des usines le long de leur cycle de vie. En effet, la variation des marges bénéficiaires est une potentiel source d’inefficience dans l’allocation des ressources, réduisant la productivité globale. En utilisant l’enquête annuelle sur le secteur manufacturé en Colombie, nous montrons une diminution de la dispersion des marges bénéficiaires avec l’âge, suggérant une convergence des marges bénéficiaires des usines avec l’âge. Nous expliquons et testons cette dynamique à travers d’une théorie d’apprentissage de la demande le long du cycle de vie (à l’exemple de la formation d’une base de la clientèle). Les nouvelles usines obtiennent une productivité et une de demande dès leur entrée et apprenent de leur demande en ajustant leur marge bénéficiaire. Au cours de leur vie, elles accumulent leur demande, ce qui entraine leur croissance et une hausse de leur marge bénéficiaire. La convergence résulte d’une inadéquation entre l’échelle optimale qu’une usine souhaite opérer compte tenu de sa productivité et son échelle de production actuel. Le modèle prédit que la grande dispersion des marges bénéficiaires à l’entrée du marché, entraine une inefficience dans l’allocation des ressources productives et reduit la productivité moyenne à des nouvelles usines. Au fur et à mesure que l’usine prend de l’age, cette friction à l’allocation diminue et contribue à augmenté la productivité moyenne des usines agées. Dans le troisième chapitre, j’étudie les gains de bien-être associés à des nouveaux investissements en infrastructures de transport. Il s’agit d’un travail de recherche con- joint avec Mathilde Lebrand de la Banque mondiale. En effet, de nombreux travaux ne prennent pas en compte la demande de services de transport lors de l’étude des gains associés à de nouveaux projets d’investissements en infrastructures. Nous développons ainsi un modèle Ricardien multi-pays, multisectoriel avec un secteur des transports dont l’équilibre est déterminer de manière endogène et qui présente deux caractéristiques prin- cipales : une diversité de modes de transport et l’absence de concurrence dans le secteur de transport. Les predictions nous montre que une hausse des investissements en in- frastructures réduisent les coûts d’expédition selon trois marges : une réduction du coût marginal des transporteurs, une diminution de la marge de profit des transporteurs et une reallocation des parts de marché vers les modes de transport les plus bénefiques. Ces deux dernières marges sont particulièrement affectées par les préférences des importateurs en matière de choix de mode de transport. / Firms’ market power has always been a topic of interest in terms of welfare and resource allocations analysis. On the one hand, market power reduces the firms’ incentive to produce, reducing consumer welfare. On the other hand, the variation in firms’ markup induces friction to input allocation and lowers aggregate productivity. With the ongoing debate on sales concentration in the US economy by a few firms, there is a lot of question concerning the causes and implications of market power. This thesis, divided into three chapters, contributes to this vast literature of studying the firm’s market power. The first chapter discusses the causes of US markup rise in an environment where firms are building intangibles assets. Indeed, over the last four decades, both the average price markups charged by firms and market shares concentration have increased. This raised concerns about market power and the extent of competition. I develop a new method to aggregate firm-level markups using the sales shares distribution. I then document three facts based on the joint distribution of markups and sales shares among publicly listed firms. First, the rise in the aggregate markup has been much less than that suggested by average markups. Second, the largest sales firms-called "superstar firms" are not at the top of the markups distribution and third, the rise in US markup has been driven by a reallocation of sales shares, jointly associated with a change in firm-level markup. To explain these trends, I develop a model where firms accumulate customers base over their life cycle by investing a fixed share of their sales. Changes in firm profitability lead to a temporary reduction in markups as firms attract new customers. An exogenous increase in the share of investment into the customer base benefits firms with high growth oppor- tunities, allowing them to gain more sales share and increase their markup. Therefore, I find that the rise in the share of investment into customer base over the last four decades explains half of the overall increase in US markup. The second chapter discusses the implications of an endogenous variation in markups to plant productivity over the life cycle. Indeed, markup varies across plants, inducing an inefficiency in allocating resources that lower the aggregate productivity. Using the Annual Columbia Manufacturing survey, I find a decrease in markup dispersion with age, suggesting a convergence of all plant-level markup with age in cross-sectional. I explain and test this dynamic through active learning on demand by plants over the life cycle (e.g. customer base formation). New plants draw a productivity shock and demand shock at entry and actively learn about their demand by adjusting their markup. Over their life, they build their demand and growth in both size and markup. This convergence results from a mismatch between the optimal scale a plant desire to operate and its current scale for a given level of productivity. The model predicts that the high variation in markups at entry induces inefficient input allocation, lowering the average productivity. Along with age, the declines in markups dispersion reduce the allocative inefficiency and foster productivity growth over the life cycle. In the third chapter, I study the welfare gain from new infrastructures investments. It is joint work with Mathilde Lebrand from the World Bank. Indeed, many frameworks don’t take into account the demand for transport services when studying trade policies. We develop a multi-countries and multi-sectoral Ricardian model with an endogenous transport sector. We introduce two main features for endogeneity: the multi-modality and a lack of competition in the transport sector. New infrastructure investments reduce the shipping cost along three margins: a transporters marginal cost reduction, a decline in the transporters profit margins and a reallocation of market shares across shipping modes. The two last margins are driven by the shipping mode preference for a good.

The role of the financial advisor is subject to fiduciary duty, which means that the advisor always should act in the best interest of the client and has traditionally referred to the financial aspects. Finance is now experiencing a revolution, where the concept of sustainable finance is on the agenda of many actors when the sustainability amendments to MiFID II entered into force, as part of the EU Action Plan on Sustainable Finance. The new regulations will add to the already intensified information load characterizing the financial advisory landscape. Moreover, this new dimension of sustainability is very different from the strictly financial one, which in itself is subject to both conceptually and operational complexity. This study aims to investigate what difficulties and complexities are arising from the growing amount of sustainability demands and information and how these affect the financial advisor and its role. This was done as a qualitative case study where nine semi-structured interviews were conducted with financial advisors working in Denmark, Finland, and Sweden, together with two interviews with employees working with sustainability at a central level in a Nordic bank. The analysis is based on the interviews combined with current literature and together lays the foundation for the findings. The key findings of the study are that there are five identified difficulties stemming from different areas that are seen as important for understanding what the inclusion of sustainability preferences into financial advisory might mean going forward, and what effects that it will have on the financial advisor: (i) regulatory changes and compliance, (ii) sustainability preferences, (iii) the information-intensive landscape, (iv) advisors’ required awareness and knowledge, and (v) the perceived advisor’s role. When adding these identified difficulties together, the conclusion is that the concept of sustainable finance is not as uncomplicated as perhaps portrayed, and this holds extra true for the studied inclusion of sustainability in the advisory process. / Den finansiella rådgivarens roll är föremål för fiduciary duty, vilket innebär att rådgivaren alltid ska agera i kundens bästa och traditionellt har hänvisat till de ekonomiska aspekterna. Finans upplever nu en revolution, där begreppet hållbar ekonomi står på dagordningen för många aktörer när hållbarhetsändringarna till MiFID II trädde i kraft, som en del av EU: s handlingsplan för finansiering av hållbar tillväxt. De nya reglerna kommer att öka den redan intensifierade informationsbelastningen som kännetecknar det finansiella rådgivande landskapet. Dessutom skiljer sig denna nya hållbarhetsdimension mycket från den strikt ekonomiska, som i sig är föremål för både konceptuell och operativ komplexitet. Studien syftar till att undersöka vilka svårigheter och komplexiteter som uppstår till följd av den ökande mängden hållbarhetskrav och information och hur dessa påverkar den finansiella rådgivaren och dess roll. Detta gjordes som en kvalitativ fallstudie där nio semistrukturerade intervjuer genomfördes med finansiella rådgivare som arbetade i Danmark, Finland och Sverige, tillsammans med två intervjuer med anställda som arbetade med hållbarhet på en central nivå i en nordisk bank. Analysen baseras på intervjuerna i kombination med aktuell litteratur och lägger tillsammans grunden för resultaten. De viktigaste resultaten i studien är att det finns fem identifierade svårigheter som härrör från olika områden som ses som viktiga för att förstå vad införandet av hållbarhetspreferenser i finansiell rådgivning kan innebära framöver och vilka effekter det kommer att få för finansiella rådgivare: (i) regeländringar och efterlevnad, (ii) hållbarhetspreferenser, (iii) det informationsintensiva landskapet, (iv) rådgivarnas medvetenhet och kunskap och (v) den upplevda rådgivarens roll. När man sammanställer dessa identifierade svårigheter är slutsatsen att begreppet hållbar ekonomi inte är så okomplicerat som det kanske framställs, och detta gäller extra för den studerade inkluderingen av hållbarhet i rådgivningsprocessen.

Durant la première moitié du XXe siècle, les membres des élites québécoises et canadiennes – des hommes pour la plupart - expriment leurs inquiétudes face à la prostitution urbaine. Ce problème existe depuis longtemps, mais considéré à l’intérieur du nouveau paysage urbain moderne, il prend une importance ainsi qu’un sens nouveau. Politiciens, médecins et réformateurs développent un discours dans lequel les femmes deviennent les seules et uniques responsables de ce que certains d’entre eux considèrent être l’un des pires fléaux de leur temps. À l’inverse, la responsabilité des hommes n’est que rarement soulignée dans ce discours. Ces élites s’entendent sur la nécessité de préserver la santé physique et morale de la société, mais c’est en ce qui a trait au modus operandi que le consensus parait moins clair. Certains d’entre eux vont mettre de l’avant une approche qui vise à contrôler la prostitution tandis que d’autres militeront pour la suppression totale de ce vice. Mais peu importe l’approche souhaitée, est-ce que le discours qui se construit autour de la répression de la prostitution au Québec à cette époque s'accompagne dans les faits d'actions concrètes pour contrer l'existence des bordels ? Notre analyse révèle que les rapports de classe et de genre sur lesquels est construit ce discours ne se reflètent qu’en partie dans la répression des acteurs et des établissements liés au milieu prostitutionnel de la ville de Québec durant l’entre-deux-guerres. D’un côté, les magistrats semblent faire preuve d’une certaine clémence à l’égard des clients. De plus, la grande majorité des maisons de débauche sont situées en Basse-ville, surtout dans le quartier Saint-Roch. D’un autre côté, force est d'admettre que les hommes sont loin d'être épargnés par la répression policière. Ils sont clients de la prostitution, mais agissent aussi en tant que proxénète et/ou tenancier.

A quantitative approach was used to investigate the stigmatization of HIV positive clients in the Leribe District of Lesotho. The study population included 5200 HIV positive patients who enrolled for ARV in government clinics. A randomly selected sample of 520 clients responded through a questionnaire and interviews. The statistical package (STATA version 9) was used to analyze data. The objectives of the study were to explore the type and level of stigmatization of HIV-positive clients and to describe ways in which health workers in the PHC can reduce the stigmatization of HIV-positive clients at the clinics. The findings revealed that types of stigmatization included separation, isolation, labeling and discrimination. Ways to reduce the stigma within a community based primary health care facility included educating people living with HIV on how to protect themselves from multiple infection, providing effective counselling to clients and families maintaining confidentiality, and using change strategies to change attitudes of health care providers. The integration of HIV-related activities is a strong recommendation and the importance of the consistent availability of ARV treatment was emphasized. / Public Health / M.A. (Public Health)

A quantitative approach was used to investigate the stigmatization of HIV positive clients in the Leribe District of Lesotho. The study population included 5200 HIV positive patients who enrolled for ARV in government clinics. A randomly selected sample of 520 clients responded through a questionnaire and interviews. The statistical package (STATA version 9) was used to analyze data. The objectives of the study were to explore the type and level of stigmatization of HIV-positive clients and to describe ways in which health workers in the PHC can reduce the stigmatization of HIV-positive clients at the clinics. The findings revealed that types of stigmatization included separation, isolation, labeling and discrimination. Ways to reduce the stigma within a community based primary health care facility included educating people living with HIV on how to protect themselves from multiple infection, providing effective counselling to clients and families maintaining confidentiality, and using change strategies to change attitudes of health care providers. The integration of HIV-related activities is a strong recommendation and the importance of the consistent availability of ARV treatment was emphasized. / Public Health / M.A. (Public Health)

Introduction: HIV referral and linkage system in many countries in general and in Ethiopia in particular was poorly characterised by low linkage rate. The purpose of this study was to analyses factors associated with poor referral and linkage system and develop strategies to improve the system. Methods: A sequential mixed method approach using exploratory descriptive study design was employed. The study was conducted in Addis Ababa, Ethiopia and it was conducted in two phases. Phase I involved data collection and analysis as evidence for the development of strategies while phase II was the development of strategies. For phase I, data were collected in steps 1 and 2 using individual interviews and focus group discussions respectively. The study participants were programme owners and partners who were supporting facilities during the data collection period in step 1 and health care providers in step 2. A total of 4 individual interviews and 3 FGDs were conducted with purposively selected participants. Data were analysed using computer assisted software called OpenCode version 4.2. Results: The findings revealed five themes namely, issues of referral and linkage practice, ensuring linkage through communication, issues of health care, issues of health care system and issues of partnerships and Health Bureau. Many gaps that affected the referral system were identified and in phase II, nine strategies were developed to strengthen the referral and linkage system. Conclusion:The results of this study highlighted weaknesses in the referral and linkage system of the HIV positive clients from counselling and testing services to chronic care and proposed strategies to strengthen those weaknesses. Measures to operationalise those strategies are also proposed. The successful implementation of the proposed strategies depends on the support of the ministry of health and regional bureau in terms of resources and the readiness of the health care providers to adhere to the proposed measures. Intervention research is needed to test the effectiveness of the proposed strategies. / Health Studies / D. Litt. et Phil. (Health Studies)

This study explores the experiences of the Swedish front-line social workers (socialsekreterare) in the municipal income support unit, Young Adults, monthly assessing the income support applications as well as daily processing the activation programs for young adult clients with mental ill-health combined with social-medicinal vulnerabilities, also referred to as young adults with complex needs. Furthermore, this study aims to illuminate the ever changing conditions of the Swedish welfare state and its underlying driving forces through the lens of the social workers. 9 Semi-structured distance interviews with 11 social workers from 6 municipalities belonging to 5 regions in Sweden, were conducted for the collection of qualitative data. It has been analyzed by the inductive-deductive coding as well as a theoretical frame consisting of concepts such as discretiona and advocacy of M. Lipsky, and reciprocal interaction (Wechselwirkung), form and contents, and call of G.Simmel. The result and analysis show that the rehabilitative approach based on the interactions and relations with the clients, is prevalent through the social workers’ processing of the activation program. It seems to be effective in a dyad, between the social workers and the client while the social workers’ discretion is maximized for the utilization of the agency (unit) activation resources. However, it proved not to be as effective in a triad or more when an extern agent outside of the unit, Young Adults begins to be involved. The tension is a fact and the social workers’ discretion is minimized when they have to process the activation program for the clients who are neither “active enough” to have a job in the ordinary labor market, nor “sick enough” to be eligible for the stately activity compensation (aktivitetsersättning) from the Social Insurance Agency (Försäkringskassan) which heavily relies on the medicinal expertise for its decision making. The social workers’ experience to fail to deliver the best possible results out of the activation programs, and the client relationship built on the rehabilitative approach turns out to be unsustainable, which can indicate the discrepancy between the rehabilitative approach as well as the activation programs, as content, and the unit, Young Adults, as form. Even though the social workers daily carry the ideological as well as the social-political tensions between the medicalization and the activation through the ever changing reality of the Swedish welfare state, their mandate to make an impact on the decision making of the activity compensation program, is rather limited, reflecting the Swedish welfare state’s expectation for the professionalism of the social workers. Rather striking that the social workers, however, confess that they in spite of the pressure of organizational efficiency as well as socio-economic discourse of digitalization undermining the concept of the unit, Young Adults, are not willing to give up the rehabilitative approach for the client’s sake but also to protect their unit, Young Adults, which postulate that they are not the gatekeepers in the agency but the advocate for the clients. In this moment, they also seem to know, and even have the call, the essential, if not mandatory, element needed to be landed in the perfect society of G. Simmel.

Home First is an Ontario transition management approach that attempts to reduce the pressure on hospital and Long Term Care (LTC) beds through early discharge planning, the provision of timely and appropriate home care, and the delay of LTC placement. The purpose of this qualitative descriptive study was to obtain descriptions from South Eastern Ontario Home First clients and their family caregivers of their experiences with and thoughts about care transitions, the provision of care, and the Home First approach. The goal was to enable insight into the Home First approach, care transitions, and the provision of care through access to the perspectives of study participants. Nine semi structured interviews (and one or more follow-up calls for each interview) with Home First clients discharged from hospitals in South East Ontario and their family caregivers were conducted and their content analyzed. All participating Home First clients were pleased to be home from hospital and did not consider LTC placement a positive option. All had family involved with their care and used a mix of formal and informal services to meet their care needs. Four general themes were identified: (a) maintaining independence while responding (or not) to risks, (b) constraints on care provision, (c) communication is key, and (d) relationship matters. Although all Home First clients participating in the study were discharged home successfully, a sense of partnership between health care providers, families, and clients was often lacking. The Home First approach may be successfully addressing hospital alternative level of care issues and getting people home where they want to be, but it is also putting increasing demands on formal and informal community caregivers. There is room for improvement in how well their needs and those of care recipients are being met. Health professionals and policy makers must ask caregivers and recipients about their concerns and provide them with appropriate resources and information if they want them to become true partners on the care team. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2013-05-23 16:10:53.323