Productivity growth and efficiency measurements in fuzzy environments with an application to health care

Health care organizations must continuously improve their productivity to sustain long-term growth and profitability. Sustainable productivity performance is mostly assumed to be a natural outcome of successful health care management. Data envelopment analysis (DEA) is a popular mathematical programming method for comparing the inputs and outputs of a set of homogenous decision making units (DMUs) by evaluating their relative efficiency. The Malmquist productivity index (MPI) is widely used for productivity analysis by relying on constructing a best practice frontier and calculating the relative performance of a DMU for different time periods. The conventional DEA requires accurate and crisp data to calculate the MPI. However, the real-world data are often imprecise and vague. In this study, the authors propose a novel productivity measurement approach in fuzzy environments with MPI. An application of the proposed approach in health care is presented to demonstrate the simplicity and efficacy of the procedures and algorithms in a hospital efficiency study conducted for a State Office of Inspector General in the United States. © 2012, IGI Global.

A méltányosság – egy kísérlet a fogalom tisztázására (The fairness: an attempt to clarify the term)

A méltányosság egyaránt szerepet játszik a társadalmi, szervezeti és szervezetközi kapcsolatokban. A szakirodalom szerint a mindkét fél által méltányosnak tekintett kapcsolatok növelik a részt vevő szervezetek aggregált eredményességét, hosszú távon a kölcsönös és közös versenyelőny kialakítását szolgálják. De mit jelent a méltányosság? A szerző ismerteti a méltányosság és a hozzá szorosan kötődő fogalmak általános meghatározását, majd megvizsgálja Arisztotelész nézeteit az igazságosságról és a méltányosságról. Érint néhány filozófiai koncepciót, melyek a társadalmi igazságosságot egymástól eltérő módon interpretálják, majd részletezi a közgazdaságtan, a kísérleti közgazdaságtan, valamint a szervezeti pszichológia legjelentősebb igazságossági és méltányossági koncepcióit. A tanulmány átfogó képet nyújt a méltányosság definícióiról az áttekintett szakirodalom és a további vállalatközi méltányosságkutatáshoz kötődő relevancia alapján. _______ Fairness plays a role in social,organizational and interorganizational relations. Relationships which are considered to be fair by both parties increase the aggregate effectiveness of the participating organizations and develop mutual and reciprocal competitive advantage in the long-run. But what does fairness mean? The author describes the general definition of fairness and its closely related notions, which is followed by a review of Aristotle’s understanding of justice and equity. Some of the philosophical concepts with different social justice interpretation are examined. The author details the most important concepts of justice, equity and fairness of economics, experimental economics, and organizational psychology. The study provides a comprehensive picture of fairness and equity definitions based on the literature overview and the relevance of further research related to inter-company fairness.

Loaxahatchee Impoundment Landscape Assessment (LILA): Tree Island Experiments and Management; May 1, 2005 to September 4, 2009: Final Report

Hydrologic modifications have negatively impacted the Florida Everglades in numerous significant ways. The compartmentalization of the once continuously flowing system into the Water Conservation Areas (WCAs) caused disruption of the slow natural flow of water south from Lake Okeechobee through the Everglades to Florida Bay. The ponding of water in the WCAs, the linking of water flow to controlled water levels, and the management of water levels for anthropogenic vs. ecological well-being has caused a reduction in the spatial heterogeneity of the Everglades leading to greater uniformity in topography and vegetation. These effects are noticeable as the degradation in structure of the Everglades Ridge and Slough environment and associated Tree Islands. In aquatic systems water flow is of fundamental importance in shaping the structure and function of the ecosystem. The organized patterns of parallel orientation of ridges, sloughs, and tear-drop shaped tree islands along historic flow paths attest to the importance of water movement in structuring this system. Our main objective was to operate and manage the LILA facility to provide a broad potential as a research platform for an integrated group of multidisciplinary, multi-agency scientists collaborating on multifunctional studies aimed primarily at determining the effects of CERP water management scenarios on the ecology of tree islands and ridge and slough habitats. We support Everglades water management, CERP, and the Long-Term Plan by defining hydrologic regimes that sustain healthy tree islands and ridge and slough ecosystems. Information gained through this project will help to reduce the uncertainty of predicting the tree island and ridge and slough ecosystem response to changes in hydrologic conditions. Additionally, we have developed the LILA site as a visual example of Everglades restoration programs in action.

Nursing case management : a new perspective to caring for patients with hip fracture

Nursing Case Management has motivated nurses to examine the effects of care provided to patients, and to devise means of improving this care. The success of this nursing care delivery model is well documented among a variety of acute and chronically ill patients. Utilizing nonparametric ANOVA for comparison of two means, this study investigates the outcome of the implementation of a nursingcase management model on an orthopedic unit of a local hospital. A convenience sample (N=149) of hip-fracture patients for two separate eight months charting periods were used. The first period was pre-case management and the second period was after the implementation of nursing managed care on the unit. Results suggested that nursing case management was effective in reducing the total length of hospital stay and post-operative days significantly.

A Knowledge Management Process-Based Approach to Support Corporate Crisis Management

In the crisis-prone and complex contemporary business environment, modern organisations and their supply chains, large and small, are challenged by crises more than ever. Knowledge management has been acknowledged as an important discipline able to support the management of complexity in times of crisis. However, the role of effective knowledge retrieval and sharing in the process of crisis prevention, management and survival has been relatively underexplored. In this paper, it is argued that organisational crises create additional challenges for knowledge management, mainly because complex, polymorphic and both structured and unstructured knowledge must be efficiently harnessed, processed and disseminated to the appropriate internal and external supply chain actors, under specific time constraints. In this perspective, a process-based approach is proposed to address the knowledge management needs of organisations during a crisis and to help management in establishing the necessary risk avoidance and recovery mechanisms. Finally, the proposed methodological approach is applied in a knowledge- intensive Greek small and medium enterprise from the pharmaceutical industry, producing empirical results, insights on knowledge pathologies during crises and relevant evaluations.

Pricing recreation use of national parks for an efficient nature conservation : an application to the portuguese case

Current institutions, research, and legislation have not yet been sufficient to achieve the conservation level of Nature as required by the society. One of the reasons that explains this relative failure is the lack of incentives to motivate local individual and Nature users in general, to adopt behaviour compliant with Nature sustainable uses. Economists believe that, from the welfare point of view, pricing is the more efficient way to make economic actors to take more environmental friendly decisions. In this paper we will discuss how efficient can be the act of pricing the recreation use of a specific natural area, in terms of maximising welfare. The main conservation issues for pricing recreation use, as well as the conditions under which pricing will be an efficient and fair instrument for the natural area will be outlined. We will conclude two things. Firstly that, from the rational utilitarian economic behaviour point of view, economic efficiency can only be achieved if the natural area has positive and known recreation marginal costs under the relevant range of the marshallian demand recreation curve and if price system management is not costly. Secondly, in order to guarantee equity for the different type of visitors when charging the fee, it is necessary to discuss differential price systems. We shall see that even if marginal recreation costs exist but are unknown, pricing recreation is still an equity instrument and a useful one from the conservation perspective, as we shall demonstrate through an empirical application to the Portuguese National Park. An individual Travel Cost Method Approach will be used to estimate the recreation price that will be set equal to the visitor’s marginal willingness to pay for a day of visit in the national park. Although not efficient, under certain conditions this can be considered a fair pricing practice, because some of the negative recreation externalities will be internalised. We shall discuss the conditions that guarantee equity on charging for the Portuguese case.

Randomized controlled trial of an intervention to change cardiac misconceptions in myocardial infarction patients

There is converging evidence that changing beliefs about an illness leads to positive recovery outcomes. However, cardiac misconceptions interventions have been investigated mainly in Angina or Coronary Heart Disease patients, and less in patients following Myocardial Infarction (MI). In these patients, cardiac misconceptions may play a role in the adjustment or lifestyle changes. This article reports a randomized controlled trial of an intervention designed to reduce the strength of misconceptions in patients after a first MI. The primary outcome was the degree of change in misconceptions and the secondary outcomes were: exercise, smoking status, return to work and mood (anxiety and depression). Patients in the intervention condition (n = 60) were compared with a control group (n = 67) receiving usual care. Both groups were evaluated at baseline and 4, 8 and 12 months after hospital discharge. There was a significant time-by-group interaction for the total score of cardiac misconceptions. Patients in the intervention group significantly decreased their total score of cardiac misconceptions at 4 months compared with the control group and this difference was sustained over time. Patients in the intervention group were also more likely to exercise at the follow-up period after MI than the control group. This intervention was effective in reducing the strength of cardiac misconceptions in MI patients and had a positive impact on health behaviour outcomes. These results support the importance of misconceptions in health behaviours and the utility of belief change interventions in promoting health in patients with Myocardial Infarction.

Holacracy as an alternative to organisations governance

Holacracy as an alternative to organisations governance A *TRS event, Room P1.2 (Fernando Pessoa Hall), University Fernando Pessoa 16th, November, 2016, Luis Borges Gouveia This presentation introduce holacracy and discuss its use as an alternative to organize people within a corporate environment. A holacracy is a governance structure characterized by a distribution of power among self-organizing groups, rather than the top-down authority in the typical hierarchical corporate culture model. A holacracy provides a flat management structure that distributes authority. The goal of a holacracy is to ensure that those responsible for completing the work have the authority to decide how that work should be carried out. Holacracy benefits are the promises to harness agility, transparency, accountability, employee engagement and innovation. It also potentiates greater efficiency. Main critics are that the model do not allow for sufficient lateral communication. Also, it use is still emerging and we do not have sufficient evidence on holacracy advantages to rely on its promises

NLG-Metricverse: An End-to-End Library for Evaluating Natural Language Generation

Driven by recent deep learning breakthroughs, natural language generation (NLG) models have been at the center of steady progress in the last few years. However, since our ability to generate human-indistinguishable artificial text lags behind our capacity to assess it, it is paramount to develop and apply even better automatic evaluation metrics. To facilitate researchers to judge the effectiveness of their models broadly, we suggest NLG-Metricverse—an end-to-end open-source library for NLG evaluation based on Python. This framework provides a living collection of NLG metrics in a unified and easy- to-use environment, supplying tools to efficiently apply, analyze, compare, and visualize them. This includes (i) the extensive support of heterogeneous automatic metrics with n-arity management, (ii) the meta-evaluation upon individual performance, metric-metric and metric-human correlations, (iii) graphical interpretations for helping humans better gain score intuitions, (iv) formal categorization and convenient documentation to accelerate metrics understanding. NLG-Metricverse aims to increase the comparability and replicability of NLG research, hopefully stimulating new contributions in the area.

Uv-vis Spectra As An Alternative To The Lowry Method For Quantify Hair Damage Induced By Surfactants.

It is well known that long term use of shampoo causes damage to human hair. Although the Lowry method has been widely used to quantify hair damage, it is unsuitable to determine this in the presence of some surfactants and there is no other method proposed in literature. In this work, a different method is used to investigate and compare the hair damage induced by four types of surfactants (including three commercial-grade surfactants) and water. Hair samples were immersed in aqueous solution of surfactants under conditions that resemble a shower (38 °C, constant shaking). These solutions become colored with time of contact with hair and its UV-vis spectra were recorded. For comparison, the amount of extracted proteins from hair by sodium dodecyl sulfate (SDS) and by water were estimated by the Lowry method. Additionally, non-pigmented vs. pigmented hair and also sepia melanin were used to understand the washing solution color and their spectra. The results presented herein show that hair degradation is mostly caused by the extraction of proteins, cuticle fragments and melanin granules from hair fiber. It was found that the intensity of solution color varies with the charge density of the surfactants. Furthermore, the intensity of solution color can be correlated to the amount of proteins quantified by the Lowry method as well as to the degree of hair damage. UV-vis spectrum of hair washing solutions is a simple and straightforward method to quantify and compare hair damages induced by different commercial surfactants.

Systemic Granulomatous Diseases Associated With Multiple Palpable Masses That May Involve The Breast: Case Presentation And An Approach To The Differential Diagnosis.

Palpable mass is a common complaint presented to the breast surgeon. It is very uncommon for patients to report breast mass associated with palpable masses in other superficial structures. When these masses are related to systemic granulomatous diseases, the diagnosis and initiation of specific therapy can be challenging. The purpose of this paper is to report a case initially assessed by the breast surgeon and ultimately diagnosed as granulomatous variant of T-cell lymphoma, and discuss the main systemic granulomatous diseases associated with palpable masses involving the breast.

T-Bar clasp-retained removable partial denture as an alternative to implant-based prosthetic treatment

This article reports the case of a 55-year-old female patient who presented with unsatisfactory temporary crowns in the right mandibular premolars and molars, and a premolar-to-molar fixed partial denture in the left side. The clinical and radiographic examinations revealed a fracture of the left first premolar that was a retainer of the fixed partial denture and required extraction. Initially, the acrylic resin crowns were replaced by new ones, and a provisional RPD was made using acrylic resin and orthodontic wire clasps to resolve the problem arising from the loss of the fixed partial denture. Considering the patient's high esthetic demands, the treatment options for the definitive prosthetic treatment were discussed with her and rehabilitation with implant-supported dentures was proposed because the clinical conditions of the residual alveolar ridge were suitable for implant installation, and the patient's general health was excellent. However, the patient did not agree because she knew of a failed case of implant-retained denture in a diabetic individual and was concerned. The patient was fully informed that implant installation was the best indication for her case, but the arguments were not sufficient to change her decision. The treatment possibilities were presented and the patient opted for a clasp-retained removable partial denture (RPD) associated with the placement of crowns in the pillar teeth. The temporary RPD was replaced by the definitive RPD constructed subsequently. Although RPD was not the first choice, satisfactory esthetic and functional outcomes were achieved, overcaming the patient's expectations. This case report illustrates that the dentist must be prepared to deal with situations where, for reasons that cannot be managed, the patient does not accept the treatment considered as the most indicated for his/her case. Alternatives must be proposed and the functional and esthetic requirements must be fulfilled in the best possible manner.

A reliable measure of similarity based on dependency for short time series: an application to gene expression networks

Background: Microarray techniques have become an important tool to the investigation of genetic relationships and the assignment of different phenotypes. Since microarrays are still very expensive, most of the experiments are performed with small samples. This paper introduces a method to quantify dependency between data series composed of few sample points. The method is used to construct gene co-expression subnetworks of highly significant edges. Results: The results shown here are for an adapted subset of a Saccharomyces cerevisiae gene expression data set with low temporal resolution and poor statistics. The method reveals common transcription factors with a high confidence level and allows the construction of subnetworks with high biological relevance that reveals characteristic features of the processes driving the organism adaptations to specific environmental conditions. Conclusion: Our method allows a reliable and sophisticated analysis of microarray data even under severe constraints. The utilization of systems biology improves the biologists ability to elucidate the mechanisms underlying celular processes and to formulate new hypotheses.

Sequential injections as an alternative to gradient exploitation for implementing differential kinetic analysis in a flow injection system

A novel flow-based strategy for implementing simultaneous determinations of different chemical species reacting with the same reagent(s) at different rates is proposed and applied to the spectrophotometric catalytic determination of iron and vanadium in Fe-V alloys. The method relies on the influence of Fe(II) and V(IV) on the rate of the iodide oxidation by Cr(VI) under acidic conditions, the Jones reducing agent is then needed Three different plugs of the sample are sequentially inserted into an acidic KI reagent carrier stream, and a confluent Cr(VI) solution is added downstream Overlap between the inserted plugs leads to a complex sample zone with several regions of maximal and minimal absorbance values. Measurements performed on these regions reveal the different degrees of reaction development and tend to be more precise Data are treated by multivariate calibration involving the PLS algorithm The proposed system is very simple and rugged Two latent variables carried out ca 95% of the analytical information and the results are in agreement with ICP-OES. (C) 2010 Elsevier B V. All rights reserved.

An alternative to the Pythagorean rule? Reevaluating Problem 1 of cuneiform tablet BM 34 568

The first problem of the Seleucid mathematical cuneiform tablet BM 34 568 calculates the diagonal of a rectangle from its sides without resorting to the Pythagorean rule. For this reason, it has been a source of discussion among specialists ever since its first publication. but so far no consensus in relation to its mathematical meaning has been attained. This paper presents two new interpretations of the scribe`s procedure. based on the assumption that he was able to reduce the problem to a standard Mesopotamian question about reciprocal numbers. These new interpretations are then linked to interpretations of the Old Babylonian tablet Plimpton 322 and to the presence of Pythagorean triples in the contexts of Old Babylonian and Hellenistic mathematics. (C) 2007 Elsevier Inc. All rights reserved.