Spesa pubblica in Sanità, Istruzione e Ricerca: efficienza, efficacia e determinanti

La ricerca intende analizzare l’efficacia della spesa pubblica, l’efficienza e le loro determinanti nei settori della Sanità, dell’Istruzione e della Ricerca per 33 paesi dell’area OCSE. L’analisi ha un duplice obiettivo: da un lato un confronto cross country e dall’altro un confronto temporale, prendendo in considerazione il periodo che va dal 1992 al 2011. Il tema della valutazione dell’efficacia e dell’efficienza della spesa pubblica è molto attuale, soprattutto in Europa, sia perché essa incide di quasi il 50% sul PIL, sia a causa della crisi finanziaria del 2008 che ha spinto i governi ad una riduzione dei bugdet e ad un loro uso più oculato. La scelta di concentrare il lavoro di analisi nei settori della Sanità, dell’Istruzione e della Ricerca e Sviluppo deriva da un lato dalla loro peculiarità di attività orientate al cliente (scuole, ospedali, tribunali) dall’altro dal ruolo strategico che essi rappresentano per lo sviluppo economico di un paese. Il lavoro è articolato in tre sezioni: 1. Rassegna dei principali strumenti metodologici utilizzati in letteratura per la misurazione della performance e dell’efficienza della spesa pubblica nei tre settori. 2. Valutazione e confronto dell’efficienza e della performance della spesa pubblica dal punto di vista sia temporale sia cross-country attraverso la costruzione di indicatori di performance e di efficienza della spesa pubblica (per approfondire l'indice dell'efficienza ho applicato la tecnica DEA "bootstrap output oriented" con indicatori di output ed input non simultanei mentre l’evoluzione dell’efficienza tra i periodi 2011-2002 e 2001-1992 è stata analizzata attraverso il calcolo dell’indice di Malmquist). 3. Analisi delle variabili esogene che influenzano l’efficienza della spesa pubblica nei settori Salute, Istruzione e Ricerca e Sviluppo attraverso una regressione Tobit avente come variabile dipendente i punteggi di efficienza DEA output oriented e come variabili esogene alcuni indicatori scelti tra quelli presenti in letteratura: l’Indicatore delle condizioni socioeconomiche delle famiglie (costruito e applicato da OCSE PISA per valutare l’impatto del background familiare nelle performance dell’apprendimento), l’Indicatore di fiducia nel sistema legislativo del paese, l’Indicatore di tutela dei diritti di proprietà, l’Indicatore delle azioni di controllo della corruzione, l’Indicatore di efficacia delle azioni di governo, l’Indicatore della qualità dei regolamenti, il PIL pro-capite. Da questo lavoro emergono risultati interessanti: non sempre alla quantità di risorse impiegate corrisponde il livello massimo di performance raggiungibile. I risultati della DEA evidenziano la media dei punteggi di efficienza corretti di 0,712 e quindi, impiegando la stessa quantità di risorse, si produrrebbe un potenziale miglioramento dell’output generato di circa il 29%. Svezia, Giappone, Finlandia e Germania risultano i paesi più efficienti, più vicini alla frontiera, mentre Slovacchia, Portogallo e Ungheria sono più distanti dalla frontiera con una misura di inefficienza di circa il 40%. Per quanto riguarda il confronto tra l’efficienza della spesa pubblica nei tre settori tra i periodi 1992-2001 e 2002-2011, l’indice di Malmquist mostra risultati interessanti: i paesi che hanno migliorato il loro livello di efficienza sono quelli dell’Est come l’Estonia, la Slovacchia, la Lituania mentre Paesi Bassi, Belgio e Stati Uniti hanno peggiorato la loro posizione. I paesi che risultano efficienti nella DEA come Finlandia, Germania e Svezia sono rimasti sostanzialmente fermi con un indice di Malmquist vicino al valore uno. In conclusione, i risultati della Tobit contengono indicazioni importanti per orientare le scelte dei Governi. Dall’analisi effettuata emerge che la fiducia nelle leggi, la lotta di contrasto alla corruzione, l’efficacia del governo, la tutela dei diritti di proprietà, le condizioni socioeconomiche delle famiglie degli studenti OECD PISA, influenzano positivamente l’efficienza della spesa pubblica nei tre settori indagati. Oltre alla spending review, per aumentare l’efficienza e migliorare la performance della spesa pubblica nei tre settori, è indispensabile per gli Stati la capacità di realizzare delle riforme che siano in grado di garantire il corretto funzionamento delle istituzioni.

Good practice guide in learning and teaching

Once again this publication is produced to celebrate and promote good teaching and learning support and to offer encouragement to those imaginative and innovative staff who continue to wish to challenge students to learn to maximum effect. It is hoped that others will pick up some good ideas from the articles contained in this volume. We had changed our editorial approach in drawing together the articles for this 2005/6 edition (our third) of the ABS Good Practice Guide. Firstly we have expanded our contributors beyond ABS academics. This year?s articles have also been written by staff from other areas of the University, a PhD student, a post-doctoral researcher and staff working in learning support. We see this as an acknowledgement that the learning environment involves a range of people in the process of student support. We have also expanded the maximum length of the articles from two to five pages, in order to allow greater reflection on the issues. The themes of the papers cluster around issues relating to diversity (widening participation and internationalisation of the student body), imaginative use of new technology (electronic reading on BlackboardTM ) and reflective practitioners, (reflection on rigour and relevance; on how best to train students in research ethics, relevance in the curriculum and the creativity of the teaching process) Discussion of efforts to train the HE teachers of the future looks forward to the next academic year when the Higher Education Academy?s professional standards will be introduced across the sector. In the last volume we mentioned the launch of the School?s Research Centre in Higher Education Learning and Management (HELM). Since then HELM has stimulated a lot of activity across the School (and University) particularly linking research and teaching. A list of the HELM seminars is listed as an appendix to this publication. Further details can be obtained from Catherine Foster (c.s.foster@aston.ac.uk) who coordinates the HELM seminars. HELM has also won its first independent grant from the EU Leonardo programme to look at the effect of business education on employment. In its annual report to the ABS Research Committee HELM listed for 2004 and 2005, 11 refereed journal articles, 4 book chapters, 3 published conference papers, 18 conference papers, one official reports and £72,500 of grant money produced in this research area across the School. I hope that this shows that reflection on learning is live and well in ABS. May I thank the contributors for taking time out of their busy schedules to write the articles and to Julie Green, the Quality Manager, for putting our diverse approaches into a coherent and publishable form.

Investigating the role of cholesterol in the formation of non-ionic surfactant based bilayer vesicles:thermal analysis and molecular dynamics

The aim of this research was to investigate the molecular interactions occurring in the formulation of non-ionic surfactant based vesicles composed monopalmitoyl glycerol (MPG), cholesterol (Chol) and dicetyl phosphate (DCP). In the formulation of these vesicles, the thermodynamic attributes and surfactant interactions based on molecular dynamics, Langmuir monolayer studies, differential scanning calorimetry (DSC), hot stage microscopy and thermogravimetric analysis (TGA) were investigated. Initially the melting points of the components individually, and combined at a 5:4:1 MPG:Chol:DCP weight ratio, were investigated; the results show that lower (90 C) than previously reported (120-140 C) temperatures could be adopted to produce molten surfactants for the production of niosomes. This was advantageous for surfactant stability; whilst TGA studies show that the individual components were stable to above 200 C, the 5:4:1 MPG:Chol:DCP mixture show ∼2% surfactant degradation at 140 C, compared to 0.01% was measured at 90 C. Niosomes formed at this lower temperature offered comparable characteristics to vesicles prepared using higher temperatures commonly reported in literature. In the formation of niosome vesicles, cholesterol also played a key role. Langmuir monolayer studies demonstrated that intercalation of cholesterol in the monolayer did not occur in the MPG:Chol:DCP (5:4:1 weight ratio) mixture. This suggests cholesterol may support bilayer assembly, with molecular simulation studies also demonstrating that vesicles cannot be built without the addition of cholesterol, with higher concentrations of cholesterol (5:4:1 vs 5:2:1, MPG:Chol:DCP) decreasing the time required for niosome assembly. © 2013 Elsevier B.V.

An exploratory study of ICT usage in small logistics service providers

Information and communication technology (ICT) developments have strongly affected supply chain management (SCM) in recent years. ICT has had a great impact on all supply chain processes including planning, purchasing, production management, stock management, physical distribution and related integration management. Technology has become an important dimension of third party logistics (3PL) service supply as competitive advantage increasingly depends on the ability to create value for customers through the effective application of ICT. Within this process, while large 3PLs are gaining substantial benefits from technology usage and implementation, the magnitude of changes spurred by ICT dissemination in small logistics service providers remains unclear. This is reflected by the existing gap in literature where the role and competitive developing processes of small 3PLs are seriously underestimated. This gives rise to the need to develop research and investigation in this particular area. The objective of this paper is to narrow the knowledge gap in the field of ICT adoption in small 3PLs through an empirical investigation. It presents the results of a survey on a sample of small Italian 3PLs.

Investigating the role of capacitive coupling between the operating table and the return electrode of an electrosurgery unit in the modification of the current density distribution within the patients’ body

Background: Electrosurgery units are widely employed in modern surgery. Advances in technology have enhanced the safety of these devices, nevertheless, accidental burns are still regularly reported. This study focuses on possible causes of sacral burns as complication of the use of electrosurgery. Burns are caused by local densifications of the current, but the actual pathway of current within patient's body is unknown. Numerical electromagnetic analysis can help in understanding the issue. Methods: To this aim, an accurate heterogeneous model of human body (including seventy-seven different tissues), electrosurgery electrodes, operating table and mattress was build to resemble a typical surgery condition. The patient lays supine on the mattress with the active electrode placed onto the thorax and the return electrode on his back. Common operating frequencies of electrosurgery units were considered. Finite Difference Time Domain electromagnetic analysis was carried out to compute the spatial distribution of current density within the patient's body. A differential analysis by changing the electrical properties of the operating table from a conductor to an insulator was also performed. Results: Results revealed that distributed capacitive coupling between patient body and the conductive operating table offers an alternative path to the electrosurgery current. The patient's anatomy, the positioning and the different electromagnetic properties of tissues promote a densification of the current at the head and sacral region. In particular, high values of current density were located behind the sacral bone and beneath the skin. This did not occur in the case of non-conductive operating table. Conclusion: Results of the simulation highlight the role played from capacitive couplings between the return electrode and the conductive operating table. The concentration of current density may result in an undesired rise in temperature, originating burns in body region far from the electrodes. This outcome is concordant with the type of surgery-related sacral burns reported in literature. Such burns cannot be immediately detected after surgery, but appear later and can be confused with bedsores. In addition, the dosimetric analysis suggests that reducing the capacity coupling between the return electrode and the operating table can decrease or avoid this problem. © 2013 Bifulco et al.; licensee BioMed Central Ltd.

Fast Information Retrieval in the Open Grid Service Architecture

This is an extended version of an article presented at the Second International Conference on Software, Services and Semantic Technologies, Sofia, Bulgaria, 11–12 September 2010.

Revisiting the lean agile paradigm:an empirical study in the aerospace industry

Much has been written about the potential impact of Lean Agile paradigm on firm's supply chain performance. However, most of the existing studies mainly pointed out Lean is for cost reduction, whereas Agility is for attaining flexibility. There are little empirical studies in literature that examined how Lean Agile paradigm impacts on supply chain performance. This paper aims to address this gap by studying the influence of Lean and Agility paradigms on a single commodity supply chain delivery performance in the aerospace industry. Data was collected from four separate 'Rigid pipes' supply chains to study how manufacturing alignment impacts on the delivery performance. Implications of the study to practitioners and academia are discussed and future research outlined.

Fenntartható fejlődés = Sustainability issues in purchasing and supply management

A fenntarthatóság kérdését a vállalati működésben számos kutatás elemzi. A vizsgálatokat azonban érdemes kiterjeszteni a vállalatokat beszállítóikkal összekötő kapcsolatrendszerre és az annak menedzseléséért felelős beszerzésre is, hiszen a nagy vállalatok beszerzési döntései jelentős értékükön keresztül fontos motiváló erőt jelentenek a beszállító vállalatok egy sokkal szélesebb hálózata számára. Tanulmányunk célja áttekinteni a fenntarthatóság három pillérjének beszerzési értelmezésének lehetőségeit, ehhez kapcsolódva bemutatni azokat a motivációs tényezőket, amelyek biztosíthatják azt, hogy a beszerzés a gyakorlatban is kezelni tudja a fenntarthatóság szempontjait. A bemutatott eredmények az irodalom feltérképezésén alapszanak, és egy olyan kutatás részét képezik, melynek során vállalati beszerzési szakembereket kérdezünk a fenntartható beszerzéssel kapcsolatos vállalati gyakorlatról és tapasztalataikról. A kutatás a Budapesti Corvinus Egyetemen folyó „Versenyben a világgal” kutatási program keretében készült. = Sustainability issues in literature are getting more and more attention. In this study the focus is extended to purchasing and supplier relationships as companies influence their supply base by the priorities of their sourcing decision. This paper addresses sustainability in purchasing in a comprehensive way including green, social responsibility and corporate growth issues. The results of a research project which aims to reveal and structure the meaning of sustainable purchasing and the motivating forces leading companies to make efforts in purchasing for sustainability and means applied to attain achievements at some fields of sustainability. After presenting the results of literature review, some theory development was done to create a framework in which it is possible to describe the sustainability means applied and the motivating force behind. This framework serves as a basis of an empirical investigation among Hungarian companies. The empirical results validated the theoretical framework: the number and the characteristics of sustainability activities were determined by the type of motivation (to avoid negative effects, compliance to expectations, to attain positive effects). Our research project was part of the research project “In Global Competition”.

Fenntarthatósági szempontok beépítése a beszállító értékelésébe a DEA/CI összetett indikátorok módszere alkalmazásával (Integrating sustainability criteria in supplier evaluation with application of the method of of DEA/CI complex indicators)

A környezeti hatások rendszerint túlmutatnak egy vállalat határain, éppen ezért az ellátási lánc kontextusban a környezeti szempontok érvényesítése során fontos szerep jut a beszerzési döntéseknek is. Számos olyan példát lehetne említeni, amikor egy adott szempont szerint egy alternatíva környezetileg előnyös, de az ellátási lánc egészét nézve már környezetterhelő. A környezeti hatások ellátási lánc szinten való mérése azonban komoly kihívásokat jelent. Ezzel jelentős kutatásokat és fejlesztéseket inspirált a téma. Az egyik olyan terület, amelyben komoly kutatási eredmények születtek, az a környezeti szempontok beszállítói értékelésbe való beépítése. A kutatások ezen irányához csatlakozva a szerzők tanulmányunkban azt keresik, hogyan lehet meghatározni az egyik legáltalánosabban használt szállítóértékelési módszerben, a súlyozott pontrendszerben egy adott szemponthoz azt a súlyt, amely mellett az adott szempont már döntésbefolyásoló tényezővé válik. Ehhez a DEA (Data Envelopment Analysis) összetett indikátorok (Composite Indicators, CI) módszerét alkalmazzák. A szempontok közös súlyának fontossága megállapításához a lineáris programozás elméletét használják. _____ Management decisions often have an environmental effect not just within the company, but outside as well, this is why supply chain context is highlighted in literature. Measuring environmental issues of supply decisions raise a lot of problems from methodological and practical point of view. This inspires a rapidly growing literature as a lot of studies were published focusing on how to incorporate environmental issues into supplier evaluation. This paper contributes to this stream of research as it develops a method to help weight selection. In the authors’ paper the method of Data Envelope Analysis (DEA) is used to study the extension of traditional supplier selection methods with environmental factors. The selection of the weight system can control the result of the selection process.

Analysis and comparison of the moral development of students required to graduate with an ethics course

Accounting students become practitioners facing ethical decision-making challenges that can be subject to various interpretations; hence, the profession is concerned with the appropriateness of their decisions. Moral development of these students has implications for a profession under legal challenges, negative publicity, and government scrutiny. Accounting students' moral development has been studied by examining their responses to moral questions in Rest's Defining Issues Test (DIT), their professional attitudes on Hall's Professionalism Scale Dimensions, and their ethical orientation-based professional commitment and ethical sensitivity. This study extended research in accounting ethics and moral development by examining students in a college where an ethics course is a requirement for graduation. ^ Knowledge of differences in the moral development of accounting students may alert practitioners and educators to potential problems resulting from a lack of ethical understanding as measured by moral development levels. If student moral development levels differ by major, and accounting majors have lower levels than other students, the conclusion may be that this difference is a causative factor for the alleged acts of malfeasance in the profession that may result in malpractice suits. ^ The current study compared 205 accounting, business, and nonbusiness students from a private university. In addition to academic major and completion of an ethics course, the other independent variable was academic level. Gender and age were tested as control variables and Rest's DIT score was the dependent variable. The primary analysis was a 2 x 3 x 3 ANOVA with post hoc tests for results with significant p-value of less than 0.05. ^ The results of this study reveal that students who take an ethics course appear to have a higher level of moral development (p = 0.013), as measured by the (DIT), than students at the same academic level who have not taken an ethics course. In addition, a statistically significant difference (p = 0.034) exists between freshmen who took an ethics class and juniors who did not take an ethics class. For every analysis except one, the lower class year with an ethics class had a higher level of moral development than the higher class year without an ethics class. These results appear to show that ethics education in particular has a greater effect on the level of moral development than education in general. Findings based on the gender specific analyses appear to show that males and females respond differently to the effects of taking an ethics class. The male students do not appear to increase their moral development level after taking an ethics course (p = 0.693) but male levels of moral development differ significantly (p = 0.003) by major. Female levels of moral development appear to increase after taking an ethics course (p = 0.002). However, they do not differ according to major (p = 0.097). ^ These findings indicate that accounting students should be required to have a class in ethics as part of their college curriculum. Students with an ethics class have a significantly higher level of moral development. The challenges facing the profession at the current time indicate that public confidence in the reports of client corporations has eroded and one way to restore this confidence could be to require ethics training of future accountants. ^

Analysis and comparison of the moral development of students required to graduate with an ethics course

Accounting students become practitioners facing ethical decision-making challenges that can be subject to various interpretations; hence, the profession is concerned with the appropriateness of their decisions. Moral development of these students has implications for a profession under legal challenges, negative publicity, and government scrutiny. Accounting students moral development has been studied by examining their responses to moral questions in Rest's Defining Issues Test (DIT), their professional attitudes on Hall's Professionalism Scale Dimensions, and their ethical orientation-based professional commitment and ethical sensitivity. This study extended research in accounting ethics and moral development by examining students in a college where an ethics course is a requirement for graduation. Knowledge of differences in the moral development of accounting students may alert practitioners and educators to potential problems resulting from a lack of ethical understanding as measured by moral development levels. If student moral development levels differ by major, and accounting majors have lower levels than other students, the conclusion may be that this difference is a causative factor for the alleged acts of malfeasance in the profession that may result in malpractice suits. The current study compared 205 accounting, business, and nonbusiness students from a private university. In addition to academic major and completion of an ethics course, the other independent variable was academic level. Gender and age were tested as control variables and Rest's DIT score was the dependent variable. The primary analysis was a 2x3x3 ANOVA with post hoc tests for results with significant p-value of less than 0.05. The results of this study reveal that students who take an ethics course appear to have a higher level of moral development (p=0.013), as measured by the (DIT), than students at the same academic level who have not taken an ethics course. In addition, a statistically significant difference (p=0.034) exists between freshmen who took an ethics class and juniors who did not take an ethics class. For every analysis except one, the lower class year with an ethics class had a higher level of moral development than the higher class year without an ethics class. These results appear to show that ethics education in particular has a greater effect on the level of moral development than education in general. Findings based on the gender specific analyses appear to show that males and females respond differently to the effects of taking an ethics class. The male students do not appear to increase their moral development level after taking an ethics course (p=0.693) but male levels of moral development differ significantly (p=0.003) by major. Female levels of moral development appear to increase after taking an ethics course (p=0.002). However, they do not differ according to major (p=0.0 97). These findings indicate that accounting students should be required to have a class in ethics as part of their college curriculum. Students with an ethics class have a significantly higher level of moral development. The challenges facing the profession at the current time indicate that public confidence in the reports of client corporations has eroded and one way to restore this confidence could be to require ethics training of future accountants.

Discharge measurements and storm event chemistry at the San Francisco River station (Planta) in 2007-2008

To improve our knowledge of the influence of land-use on solute behaviour and export rates in neotropical montane catchments we investigated total organic carbon (TOC), Ca, Mg, Na, K, NO3 and SO4 concentrations during April 2007-May 2008 at different flow conditions and over time in six forested and pasture-dominated headwaters (0.7-76 km2) in Ecuador. NO3 and SO4 concentrations decreased during the study period, with a continual decrease in NO3 and an abrupt decrease in February 2008 for SO4. We attribute this to changing weather regimes connected to a weakening La Niña event. Stream Na concentration decreased in all catchments, and Mg and Ca concentration decreased in all but the forested catchments during storm flow. Under all land-uses TOC increased at high flows. The differences in solute behaviour during storm flow might be attributed to largely shallow subsurface and surface flow paths in pasture streams on the one hand, and a predominant origin of storm flow from the organic layer in the forested streams on the other hand. Nutrient export rates in the forested streams were comparable to the values found in literature for tropical streams. They amounted to 6-8 kg/ha/y for Ca, 7-8 kg/ha/y for K, 4-5 kg/ha/y for Mg, 11-14 kg/ha/y for Na, 19-22 kg/ha/y for NO3 (i.e. 4.3-5.0 kg/ha/y NO3-N) and 17 kg/ha/y for SO4. Our data contradict the assumption that nutrient export increases with the loss of forest cover. For NO3 we observed a positive correlation of export value and percentage forest cover.

Ser cuidador de paciente com acidente vascular cerebral: histórias não contadas

The present study aimed to understand the experience of being a family caregiver of a patient with Cerebrovascular Accident (CVA). The relevance of the study is to prove existence of a large number of caregivers of incapacitated patients, due to the CVA and it is not an academic research object, according to the literature. It is a qualitative research, which the guiding principle is the oral history of life, according to the theoretical foundation and operating of Meihy. Therefore, the following steps were highlighted: the target community, composed of all family caregivers of CVA patients; the colony, composed by family caregivers of CVA patients assisted by Home Care Service (HCS) of the Hospital José Pedro Bezerra (HJPB), in the city of Natal/RN; the network was composed of six caregivers who met the criteria for inclusion, and as zero point the first volunteer group. The population was composed of all family caregivers of patients attended by the HCS, of the HJPB having been addressed through interviews. For the empirical research there was the consent of that institution and approval by the Ethics Committee in Research of the Federal University of Rio Grande do Norte as CAAE 24569413.0.0000.5537 and, above all, with the acquiescence of employees in participating in the investigation, signing an informed consent. Of the empirical material, five categories of analysis were identified: the sense of being a caregiver; what has changed in the life of the caregiver; the feelings emerge in the relationship of care; the distance from family and friends; difficulties faced by the caregiver. The results show that the caregiver's life goes through profound transformations within the family as well as in all spheres of life. For the caregivers, assuming the care of a relative with CVA means renunciation and donation, compromising sometimes the individual projects and the family as a whole. In addition, they point out the confrontation of difficulties within the the assistance and humanization in healthcare, information, physical and emotional overload, as well as financial problems. Despite all the adversities that compromise the caregiver's life, it was possible to identify attitudes of resilience among caregivers, making them their daily life less strenuous and with more lightness. It is expected, therefore, that this research can contribute to a better orientation of professionals with the caregivers

Implementing restorative justice practice in schools: what pedagogy reveals

In the ongoing pursuit for creating safe, nurturing and relational school cultures, educators continue to turn to restorative justice (rj) principles and practice. Predominantly, schools begin to engage with rj in an effort to address harm done, causing its discourse to be situated in literature tied to classroom management and behaviour. However, in this location, the effectiveness of rj can be limited because the power relationships underlying the original punitive, managerial structures maintain their grip. Drawing on a qualitative study that examines the experiences of educators committed to implementing rj principles, this article explores how placing rj in the context of engaged, productive pedagogies better nurtures the hoped for relational and peaceful school culture.