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.

As escolas polivalentes do Triângulo Mineiro e Alto Paranaíba (MG): sondagem vocacional no projeto desenvolvimentista civil-militar (1965–1976)

This study has as object eight state vocational schools located in Araguari, Araxá, Frutal, Ituiutaba, Monte Carmelo, Patos de Minas, Uberaba and Uberlândia, in Minas Gerais. The period analyzed comprises the years from 1965 to 1976, from the signature of the Agreement 512-11-610-042 beteween the Ministry of Education and Culture (MEC) and the American Agency for International Development (USAID), which started a series of other agreements, and actions ending up with the creation of the Expansion and Improvement of High Schools Program (Programa de Expansão e Melhoria do Ensino Médio - PREMEM) and, from this, the Vocational Schools. The upper limit of the study, 1976, was the year when these agreements, known as MEC/USAID agreements ceased. The Vocational Schools were characterized as vocation probing schools, directing the professional formation of the population in general, which would happen a posteriori, turning it shorter and more effective, since the labor market would demand, urgently, capable professionals for an expanding economy. The project of Vocational Schools had a national scope, and foresaw, for its unfolding, the complete substitution of State Schools for the new model, called “multi-curricula”. The theme Vocational schools was the object of my Master’s degree study, when I focused the State School Guiomar de Freitas Costa, in Uberlândia. That study raised questionings and concerns that resulted in the central problem of the thesis presented here: understanding the measure in which such schools integrated the country’s development project – mostly in the first half of the military rule – and to understand its structure, functionality and efficacyThe development of the study presented here, demanded the use of several sources: 1) specialized literature about the topics presented, i.e., the situation of national education in a temporal analysis, the political, economical and social context, research methodologies, the theory of human capital, vocational teaching, pedagogical trends and practices, agreements MEC-USAID and PREMEM; 2) national, state and county laws related to the discussion: laws of national education directives and basis, decrees and reports stating about the program of technical cooperation between Brazil and the United States of America, the Program of Expansion and Improvement of Teaching (PREMEM), formation of professors, establishment of Vocational Schools and educational planning; 3) documentation of school archives: books of minutes of Collegiate and of faculty and staff, registrar books with final scores, enrolment, visits of inspector, accounting books, punch clock records, student, professor and staff occurrences, inventory, class schedules, school year calendar, school rules, class reports, payment rolls, bills of sales, exchanged mail, personal documentation of professional personnel, documents of land acquisition, blueprints, manuals of PREMEM, didactic materials/resources used in classes, books available in the school library, structured evaluations for follow-up of school processes, pictures of events, texts prepared for special dates, and news from the official newspaper and, finally, 4) national and local press reports, especially from Folha de São Paulo, Correio de Araxá, Correio de Uberlândia and Lavoura e Comércio (Uberaba). The proposition of Vocational schools was conciliate theoretical and practical formation through an active education permeated by technological resources. The contact with knowledge and several practical activities under professional supervision, the student would identify the knowledge area that would interest him the most and his aptitude. This formation in primary school would make way for the vocation studies in high school, which became mandatory by the law 5.692/71, that reformed school education from the previous levels of elementary, middle high and high school. However, the multi-curricula proposal that would be spread to the other public schools in the country ended up succumbing to the model already established. From its ephemeral existence, maybe the Vocational Schools have not reached the more general goals in political, economic and social aspects; however, this study demonstrated that, for the people that, directly or indirectly, had contact with such schools, a legacy of vocational and quality teaching was made, so much so, that forty years after the end of that proposal, they are still remembered.

Residuos de Ivermectina en carne bovina en Matadero Novaterra S.A -Tipitapa Enero – Junio 2015

El presente estudio se realizó en el Matadero NOVATERRA S.A, municipio de Tipitapa - Managua ubicado en el km 42 carretera panamericana norte, con el objetivo de evaluar los niveles de residuos de ivermectina en productos cárnicos para la exporta ción, el impacto económico causado por el mal manejo y las procedencias de reses que resultaron con residuos mayores a 10ppb, se muestrearon lotes ganadero de los diferentes departamentos del país durante el periodo Enero - Junio 2015, donde la escogencia d e las reses a muestrear se realizó en los corrales, las muestras se tomaron en la sala de sacrificio por un inspector auxiliar del SIC y un Inspector HACCP, estas se extrajeron a nivel de la escápula (paleta), se identificaron con su respectiva tarjeta y s e enviaron al laboratorio donde fueron analizadas a través del método analítico Físico - químico HPLC (cromatografía líquida de alta resolución). Los resultados obtenidos nos indican que el 86.23% del total de muestra no reveló residuos de ivermectina, en el 13.65% de las reses se detectó residuos menores a 10ppb y el 0.10% resultó con residuos superiores al límite permisible, donde Managua presentó ser el departamento con mayor prevalencia de reses con residuos de ivermectina no permisible debido a que es un acopiador de ganado de los diferentes departamentos del país. Las pérdidas económicas provocadas por condena de las reses que resultaron con niveles superiores a los LMR (Límites Máximos de Residuos) fueron de $33,582.1, concluyendo que la prevalencia de este desparasitante en la carne se debe al uso inadecuado de los productos veterinarios y al irrespeto del período de retiro en carne de dicho producto

Educación ambiental en la gestión ambiental pública de Nicaragua: análisis a partir de inspectores y educadores ambientales

La presente investigación es resultado del trabajo final de la maestría, cursada en el Programa de Pós-graduación en Educación Ambiental de la Universidad Federal de Rio Grande (FURG), en la línea de Educación Ambiental no formal. La investigación tuvo como objetivo analizar la educación ambiental en la gestión ambiental pública, a partir de la práctica de inspectores y educadores ambientales de Nicaragua, a la luz de los presupuestos y aportes de la Educación Ambiental (E.A) en los procesos de Gestión Ambiental (G.A). Los procedimientos metodológicos se desarrollaron bajo un abordaje cualitativo. Para la colecta de datos se hizo uso de la investigación bibliográfica y del método de encuesta. La metodología de análisis de datos siguió los presupuestos teóricos del Análisis Textual Discursivo (ATD). Con el análisis se evidenció que la práctica educativa es predominantemente conservacionista y pragmática. Se identificaron elementos favorables, dentro de la política educativa, para fomentar procesos dentro de una perspectiva crítica, sin embargo son poco retomadas y evidentes dentro de los planes que guían las acciones de Educación Ambiental. La E.A. no es vista como área complementar de la G.A, pero sí como un instrumento, que se integra y aplica a los procesos de formación dentro de sus áreas de acción.

Charakter ekologiczny opłaty produktowej

W niniejszym opracowaniu dokonano analizy opłaty produktowej ponoszonej w przypadku niezapewnienia wymaganego poziomu zbierania zużytych baterii i zużytych akumulatorów przenośnych. Ponadto podjęto próbę zdefiniowania terminu „opłata produktowa”. W opracowaniu przedstawione zostały także cechy tej opłaty oraz jej rola jako rodzaju opłaty ekologicznej. Podstawową metodą badawczą jest metoda analityczna uzupełniona przez metodę dogmatyczno-egzegetyczną. Analizie poddano przede wszystkim poglądy wyrażone w literaturze przedmiotu. Ponadto odwołano się do wykładni przepisów ustawy z dnia 24 kwietnia 2009 r. o bateriach i akumulatorach. Źródłem danych empirycznych były raporty o funkcjonowaniu gospodarki bateriami i akumulatorami oraz zużytymi akumulatorami sporządzone przez Głównego Inspektora Ochrony Środowiska za lata 2010-2014. W opracowaniu uwzględniono stan prawny na dzień 31 marca 2016 r.

Propuesta de mejora en el proceso de inspecciones planeadas de Eternit Colombiana S.A. en el área de producción de placas 1 y placas 2 bajo la norma sistema de clasificación internacional de seguridad (ISRS)

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Review of Preventative Controls for Fraud, Waste, and Abuse in the Supplemental Nutrition Assistance Program (SNAP), Department of Social Services

This review of preventative controls for fraud, waste, and abuse in the Supplemental Nutrition Assistance Program (SNAP), administered by the Department of Social Services, was self-initiated by the State Inspector General as part of a broader statewide review of preventative fraud, waste, and abuse management controls of major benefit programs in State agencies. This review’s scope and objectives were: Assess SNAP’s preventative management controls for fraud, waste, and abuse; Identify SNAP preventative management control best practices; and Identify opportunities to improve SNAP management controls to cost/effectively mitigate risks of fraud, waste, and abuse.

Review of Program Integrity Operations At Six Managed Care Organizations Delivering Medicaid Services under a Contract with the South Carolina Department of Health & Human Services

The State contracted with six managed care organizations to deliver Medicaid managed care at an annual cost of $2.7 billion, representing 10% of the State’s annual budget, to 750,000 Medicaid beneficiaries in South Carolina. This review’s scope and objectives were: Test the six MCOs’ compliance and effective execution of the SCDHHS’s managed care contract “Section 11 - Program Integrity” focusing on the operational components of pre-payment review and post-payment review. Identify opportunities to improve SCDHHS’s biennial managed care contract, contract monitoring, and MCO compliance and effective execution of the contract.

Review of the Community Residential Care Facilities Program, Department of Health and Environmental Control

This review was predicated on a credible complaint alleging substantial health and safety deficiencies in the care of a resident placed in a Community Residential Care Facility (CRCF) in Kershaw County, South Carolina. Initial investigation with subject matter experts, non-profit advocacy groups, and CRCF inspection reports revealed this single incident might be a symptom of systemic health and safety deficiencies throughout DHEC’s CRCF Program, which regulates 471 CRCFs with the approximately 17,000 vulnerable clients, primarily elderly and disabled. This review’s scope and objectives were: Assess the risk of a vulnerable population of elderly and disabled citizens residing in CRCFs living in unsatisfactory health and safety conditions; Evaluate DHEC’s CRCF Program inspection process capabilities to identify and address CRCFs with unsatisfactory health and safety living conditions; Recommend opportunities to improve the CRCF Program.

Review of Two Issues at the Long-Term Commitment Facilities, Department of Juvenile Justice: 1)Safety Threat to Employees & Juveniles; and 2)Event Reporting Process Integrity Allegations

The Legislative Oversight Committee of the South Carolina House of Representatives, referred allegations pertaining to the Department of Juvenile Justice (DJJ) which were generated during its ongoing oversight study of DJJ. Specifically, the safety issues focused on lack of control; lack of trust; and lack of adequate staffing. This review’s scope and objectives were: Investigate specific complainant allegations of DJJ employees underreporting, misreporting, or destroying ERs; Review the efficiency and effectiveness of DJJ’s event reporting process and follow-up on anomalies or potential patterns of systemic underreporting, misreporting, or missing ERs; and Assess juvenile and employee safety conditions through interviewing a cross-section of relevant employees, record review, and possibly an employee survey.

Fiscal Year 2015-16 Accountability Report

The South Carolina Office of Inspector General reports to the Office of State Budget its annual accountability report that includes an executive summary, organization chart, statistics, strategic planning, HR information, and key agency-specific results.

Review of Abuse, Neglect, and Exploitation Allegations Involving SC Mentor, a Private Provider for the South Carolina Department of Disabilities and Special Needs

This review was requested by the Department of Disabilities and Special Needs for an independent review of allegations of abuse, neglect, and exploitation at SC Mentor, a private provider of residential services for DDSN consumers. An analysis of incidents did not indicate systemic abuse towards consumers inasmuch as the majority of the ANE reporting system contained allegations more akin to staff/facility performance issues and the vast majority of all allegations were unsustained by independent investigations. In the future, DDSN should expand the level of detail in its ANE reporting, which currently only reports total allegations and sustained criminal incidents.

Allegation of a Violation of the State Procurement Code and Other Issues Related to a Statewide Term Contract Involving the Department of Revenue and the Department of Health and Environmental Control

A complainant alleged the Department of Revenue violated the South Carolina Procurement Code. This paper examines that complaint.

Review of Managing the Fraud Risk in the Disaster Supplemental Nutrition Assistance Program (D-SNAP), Administered by the Department of Social Services

This review was initiated based upon allegations from multiple sources of possible fraud in the Disaster Supplemental Nutrition Assistance Program (D-SNAP) administered by the South Carolina Department of Social Services (SCDSS), which was implemented in response to the 10/3/2015 statewide flooding from Hurricane Joaquin. This review’s scope and objectives were: Assess SCDSS’s D-SNAP implementation for compliance with federal guidelines, with emphasis on fraud preventative controls; Assess the SCDSS’s post-disaster review and audit methodology for compliance with federal guidelines, with emphasis on understanding the fraud risks and resolution strategies; and Identify residual risk/suspected fraud not addressed through the SCDSS review and available opportunities to address.

Intereses económicos y políticos versus identidad cultural del corregimiento de Belén de Bajirá

En Colombia, el ordenamiento territorial debe ser una política de estado, un instrumento estratégico para el desarrollo del país que debe tener una visión de largo plazo y debe tener como objetivos la sostenibilidad de recursos naturales, la preservación de la biodiversidad y reconocimiento de servicios eco sistémicos, la equidad en el acceso a los servicios e infraestructura, la preservación del patrimonio étnico y cultural además de incentivar la competitividad con perspectiva de responsabilidad territorial. Es precisamente en la zona de Urabá, entre el límite entre Chocó y Antioquia donde existe un corregimiento llamado Belén de Bajirá, el cual se encuentra en un conflicto territorial hace 16 años. Los dos departamentos se disputan la posesión de este corregimiento que tiene un censo de 16 mil habitantes, un inspector de policía, rector de colegio, recaudador de impuestos que no se pueden cobrar, asimilando un gobierno paralelo; este trabajo de grado busca explicar o dilucidar las causas por las cuales esta diferencia limítrofe ocurrió y dar posibles soluciones.