Abstract
The relation between academic integrity and real world corruption is more often presumed than proven. Based on a sample of 7,602 students from 21 countries, it was found that academic cheating in the past is a predictor of the countries' current level of corruption. This reproducibility and persistence over time of dishonest behaviors highlights the danger of disregarding students cheating at university. © 2013 Springer Science+Business Media Dordrecht.

Abstract

Abstract
Understanding how VMI benefits serve lean purposes in healthcare and why its outcomes can be difficult to achieve in healthcare settings is the main purpose of this study. An in?depth case study of VMI is presented in the perspective of the downstream member, a public general multi?site hospital, operating as a small scale consolidated service centre in terms of material management, exploring such dimensions as: VMI benefits, risks, barriers and enablers. Despite some unawareness of VMI benefits in healthcare, it can present a waste reduction solution not only in costs but in the quality of care for freeing clinical professionals to clinical tasks, among other savings. The multiple benefits are better explored, as in any relationship building, by investing in partnership creation and overcoming the idiosyncratic barriers of the healthcare sector. Although findings of a single case study are difficult to generalize, the protocol and methodology presented allow replication in other units of analysis with the same inclusion criteria. This paper brings the lean deployment discussion out of the organization's boundaries, showing the interconnections and pointing to the need for future work that would allow healthcare managers to build a lean supply chain. By considering VMI an outsourcing alternative, this paper identifies the lean thinking intent behind such options and enhances the idiosyncratic difficulties in full deployment in the healthcare sector, a less studied setting. © 2013, Emerald Group Publishing Limited

Abstract
Considering lean thinking inside and beyond the organisation's boundaries, in the extended supply chain, this paper aims to fill a literature gap clearly stating some outsourcing practices as lean practices and establishing a deployment evolution parallel between both practices. A literature review was carried out collecting cases of lean deployment in healthcare, from both scientific and grey literature. Cases were classified according to lean deployment taxonomy in healthcare settings, showing some differences in lean journey stages in 15 countries. There is an alignment between SCM thinking in healthcare and lean thinking that places a SCM decision as outsourcing as a lean practice serving not only strategic intent but solving operational efficiency. There is a match between different outsourcing drivers (transactional, strategic and transformational) and lean maturity levels. The main constraint to deployment of both lean and outsourcing practices are cultural differences. Understanding lean and outsourcing different deployment maturity levels under the national cultural umbrella can open new perspectives to study lean sustainability factors and better outsourcing relationships in healthcare organisations. This paper presents a merger between the state?of?the art of both lean and outsourcing practices in healthcare settings and suggests an outsourcing and lean evolving pathway. © 2013, Emerald Group Publishing Limited

Abstract
Healthcare organisations, especially in public sector, have been adopting Lean management practices with increasing outcomes’ evidences in several parts of the world, since the beginning of this century. However, Lean deployment in Healthcare services has been addressed in the literature in a surgical way by an array of case reports addressing the “hard” side of Lean deployment, sometimes with no result’s consistency or even follow-up analysis. This thesis seek to add to the operational side of Lean deployment in Healthcare, a complementary understanding of Lean deployment approaches, addressing both “hard” and “soft” sides, identifying the real constraints of Lean in Healthcare sector and the sustainability factors. Supported by two main literature reviews and a multi-case approach, a deep research on the eligible Portuguese cases was conducted answering the questions: (i) What are the different outcomes from Lean deployment in Healthcare?; (ii) What are the barriers to Lean implementation in Healthcare?; (iii) What enables Lean implementation in Healthcare?; (iv) What are the risks of Lean in Healthcare?; (v) How to measure Lean achievements in Healthcare services?; and (vi) How to develop a sustainable Lean culture? This contribution to the academic debate on Lean deployment in Healthcare creates clarity on what can be called Lean practices in Healthcare settings under the light of the concept’s founders; what pattern of a Lean deployment journey was followed by Healthcare organisations; and how different cultural (organisational and national) contexts can influence the pace in pursuing that pattern.;As organizações de saúde, nomeadamente públicas, têm vindo a adoptar práticas de gestão Lean com crescente evidência de resultados em várias partes do mundo, desde o início deste século. Contudo, a aplicação do Lean em serviços de saúde tem tido um tratamento cirúrgico na literatura, recaindo apenas nos aspectos “hard” e sem grande consistência ou seguimento de resultados . Esta tese pretende acrescentar aos aspectos “hard” do Lean, um entendimento complementar juntando os aspectos “hard” e “soft”, identificando as restrições e factores de sustentabilidade da aplicação do Lean no sector da saúde. Tendo por base duas revisões bibliográficas primordiais e uma abordagem empírica multi-caso a partir de casos portugueses elegíveis, esta tese fornece respostas às questões: (i) Quais os diferentes resultados da aplicação do Lean na Saúde?; (ii) Quais as barreiras à aplicação do Lean na Saúde?; (iii) Quais os facilitadores da implementação do Lean na Saúde?; (iv) Quais os riscos do Lean na Saúde?; (v) Como medir a implementação do Lean na Saúde; e (vi) como desenvolver uma cultura Lean sustentável? Este contributo para o debate académico sobre a aplicação do Lean na Saúde introduz clareza sobre o que pode ou não ser chamado de práticas Lean na Saúde tendo como referência os conceitos dos fundadores; que padrão de implementação é seguido pelas organizações; e de que forma diferentes contextos culturais (nacionais e organizacionais) influenciam o ritmo desse padrão de implementação.

Abstract
This paper studies inefficiencies arising in oligopolies subject to environmental regulation based on tradable emission permits. We propose a duopoly model of upstream-downstream strategic competition: in the permits market a leader sets the price, whereas in the output market Cournot competition occurs. We find that strategic interaction in the output market gives rise to an additional distortion in the permits market where both firms adopt rival's cost-rising' strategies to gain a competitive advantage in the output market. As a result, the price of permits is always higher than firms' marginal abatement costs.