Abstract Physicians in the emergency department (ED) are facing a number of unique challenges in the currently changing healthcare and economic climates. Dramatic increases in ED patient volumes have been noted nationwide with visits related to prescription opioid abuse and misuse alone having increased by 111% between 2004 and 2008. Ironically, several challenges ED physicians are facing arise from regulatory and economic initiatives which were originally designed for the protection of patients. Regulatory requirements to address pain as the fifth vital sign, along with entities utilizing patient satisfaction based reimbursement, have inadvertently created an environment conducive to exploitation by the prescription opioid abuser. A literature review revealed an informational gap with regard to the impact economic and regulatory factors exert on the management of patients, exhibiting drug seeking behavior, by ED physicians. The lack of available information is the basis for this original research. A descriptive, cross-sectional, non-experimental study was conducted over a two month period (October - November, 2013) to elicit opinions of ED physicians regarding the management of opioid seeking patients. Respondents were asked to include opinions on factors perceived to impact treatment of this patient population. Of the ED physicians surveyed, 71% reported a perceived pressure to prescribe opioids to avoid administrative and regulatory criticism and 98% perceive patient satisfaction scores as being too highly emphasized by reimbursement entities as a means of evaluating healthcare quality. Rising patient volumes and changes in the healthcare climate were also cited as factors impacting management practices when treating patients exhibiting drug seeking behavior. Emergency department physicians have a unique role in providing unrestricted access of care for the public. This role, in conjunction with the aforementioned concerns, has served to create an environment conducive to the potentiation of prescription opioid misuse and abuse.

Rural tourism has been widely promoted in the European Union as an effective measure counteracting economic and social challenges facing rural areas especially those with declining agriculture economies. Particularly its role is seen in provision and maintenance of public goods which are more and more demanded by the public and considered in the policymaking. In Kosovo, rural tourism has been developed through the support of the international organizations and private sector initiatives, with primary aim to generate additional income for rural households and sustainable management of natural and cultural resources. Anyhow, it could be stated that the use of territorial capital to enhance the quality of the tourist offer and undertake promotion at wider circles of people has not been well explored so far, particularly possible links with agriculture that would satisfy visitors demand. In this regard this research study analyzes involvement of local stakeholders and use of territorial capital to develop tourist offer in rural areas of Kosovo. Beside, study applies comparative approach with other two areas of the European Union, Appennino Bolognese in Italy and Alpujara in Spain, to understand and compare the process of rural tourism development and demand characteristics between Kosovo and these areas. A survey has been conducted in all three study areas with rural tourism visitors to understand their preferences for public and private goods and services when visiting rural areas and the role of agriculture in sustaining rural tourism. Results show that there is a potential to link rural tourism with agriculture in Kosovo, which would help in sustaining agriculture and add additional value to local food products, which in return would enhance the tourist offer and make it more attractive for the visitors but also for the farmers as an additional revenue generating sector.

A growing number of empirical studies recently investigated consumers' valuation for local food products. However, different aspects related to the local food consumption still remain vague or unexplored. As such, the objective of the present research is to fulfill the existing literature using a mixed methodological approach for the investigation of consumers' preferences and Willingness to Pay (WTP) for local food products. First of all, local food is still a blurred concept and this factor might be source of individuals' misperception for the local origin meaning. Therefore, a qualitative research has been performed in order to investigate the meaning and the perception of the local food in the Italian food market. Results from this analysis have been used as inputs for the building of a non-hypothetical Real Choice Experiment (RCE) to estimate consumers' WTP for locally and organically produced apple sauce. The contribution of this study is three-fold: (1) consumers' valuation for the local origin is interpreted in terms of regional borders, over the organic food claim in case of an unusual food product in the area of interest, (2) the interaction between individuals' personality traits and consumers’ preferences for local and organic foods is analyzed, (3) the role of Commitment Cost creation in consumers' choice making in case of uncertainty due to the use of a novel food product and of an unconventional food claim is investigated. Results suggest that consumers are willing to pay a higher price premium for organic over locally produced apple sauce, possibly because of the presence of a regulated certification. In accordance with Commitment Cost theory, the organic label might thus decrease consumers' uncertainty for the features of the product in question. Results also indicate that individuals' personality can be source of heterogeneity in consumers' preferences.

Il settore suinicolo ricopre un ruolo rilevante nel contesto nazionale, con ricadute economiche e sociali di primaria importanza in varie regioni. Tuttavia da alcuni anni il settore si trova in crisi a causa dell’instabilità dei mercati internazionali, dello scarso coordinamento tra gli attori della filiera, della progressiva riduzione della redditività dei prodotti trasformati a Denominazione di Origine, della mancata valorizzazione dei tagli di carne fresca, nonché della difficoltà di aggredire i mercati esteri. Altre criticità riguardano la distribuzione del valore lungo la filiera e la scarsa efficacia delle politiche di coordinamento finora adottate. L'obiettivo della ricerca è quello di identificare gli elementi che possono garantire maggiore equilibrio di potere negoziale tra allevatori suinicoli e macellatori rispetto alla situazione attuale: verificati gli elementi critici che caratterizzano la relazione commerciale tra allevatori e macellatori, si avanzano alcune proposte operative utili al superamento delle fratture tra la componente agricola e quella dei macelli in Emilia Romagna. La struttura della tesi è la seguente: (capitolo 1) si descrive il quadro economico del settore suinicolo a livello internazionale e nazionale. Successivamente (capitolo 2) si passano in rassegna le teorie economiche utili a comprendere le ragioni alla base del malfunzionamento dei rapporti tra gli attori della filiera agroalimentare, mentre nel terzo capitolo è richiamato il quadro normativo comunitario, nazionale e regionale all’interno del quale tali relazioni si configurano. Nel quarto capitolo si elabora un modello interpretativo al fine di spiegare le fratture che oggi contraddistinguono le relazioni in essere tra gli attori della filiera: il “modello delle fratture”. Alla luce di questa concettualizzazione è stata svolta un’indagine diretta svolta presso gli operatori aderenti all’Organizzazione Interprofessionale del Gran Suino Italiano, i cui risultati hanno consentito di valutare l’efficacia del modello interpretativo e di fornire indicazioni migliorative della strategia di governance delle relazioni tra allevatori e macellatori. / The Italian pig industry has a role of great importance in the national context, with social and economic impact of primary importance in some specific areas, us Emilia Romagna region. However, the sector is facing a number of difficulties: the instability of the international markets, lack of coordination among the economic actors in the sector, the gradual reduction in the profitability of some Protected Designation of Origin products. Furthermore, a critical issue is represented by the imbalance in the distribution of value along the supply chain and also by the lack of effective coordination of policies among the actors. The aim of the research is to identify the elements that can ensure greater balance of bargaining power between pig farmers and processors: first of all the research verifie the critical elements of the relationship between farmers and slaughterers and the figures out some practical proposals useful in overcoming the divisions between the agricultural component and the slaughterhouse in Emilia Romagna, as the need to strengthen the coordination in the supply chain and to adopt written contracts.

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