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.

A Plausibilidade da Interpretação da Religião pela Literatura Uma proposta fundamentada em Paul Ricoeur e Mikhail Bakhtin exemplificada com José Saramago

Religião e literatura é o tema geral desta tese de doutoramento. Contudo, a preocupação específica é a plausibilidade da interpretação da religião pela literatura. Isso porque os estudiosos dessa área têm normalmente partido da pressuposição de que essa plausibilidade existe. Por isso geralmente não a problematizam e nem se preocupam em fundamentá-la. A proposta desta pesquisa é justamente desenvolver um embasamento teórico que ajude a suprir essa lacuna. Portanto, esta tese mantém como preocupação de fundo uma questão epistemológica. Para levar adiante esse projeto, levanta-se a hipótese de que o discurso indireto da literatura caracterizado pela metáfora, especialmente o romance com a sua possibilidade polifônica e carnavalesca, tem a capacidade de revelar traços específicos do fenômeno religioso de modo diferente do que fazem os discursos diretos da filosofia e das ciências, de tal forma que dá à literatura condições de proceder a uma interpretação plausível e heurística da religião. A fundamentação teórica para o desenvolvimento da hipótese é baseada na teoria da metáfora, do texto e da narrativa de Paul Ricoeur e nos conceitos de dialogismo, polifonia, carnavalização e literatura prosaica de Mikhail Bakhtin. Com a finalidade de exemplificar, na prática, a pertinência do material teórico desenvolvido, o romance O Evangelho Segundo Jesus Cristo, de José Saramago é interpretado. Metodologicamente, o trabalho está dividido em três pontos: primeiro a literatura e o conhecimento da realidade; segundo a literatura como intérprete da religião e terceiro, a interpretação exemplar do romance.(AU)

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.

Learning to live with Parkinson’s disease in the family unit:an interpretative phenomenological analysis of well-being

We investigated family members’ lived experience of Parkinson’s disease (PD) aiming to investigate opportunities for well-being. A lifeworld-led approach to healthcare was adopted. Interpretative phenomenological analysis was used to explore in-depth interviews with people living with PD and their partners. The analysis generated four themes: It’s more than just an illness revealed the existential challenge of diagnosis; Like a bird with a broken wing emphasizing the need to adapt to increasing immobility through embodied agency; Being together with PD exploring the kinship within couples and belonging experienced through support groups; and Carpe diem! illuminated the significance of time and fractured future orientation created by diagnosis. Findings were interpreted using an existential-phenomenological theory of well-being. We highlighted how partners shared the impact of PD in their own ontological challenges. Further research with different types of families and in different situations is required to identify services required to facilitate the process of learning to live with PD. Care and support for the family unit needs to provide emotional support to manage threats to identity and agency alongside problem-solving for bodily changes. Adopting a lifeworld-led healthcare approach would increase opportunities for well-being within the PD illness journey.

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.

The Enchanter's Spell: J.R.R. Tolkien's Mythopoetic Response to Modernism

J.R.R. Tolkien was not only an author of fantasy but also a philologist who theorized about myth. Theorists have employed various methods of analyzing myth, and this thesis integrates several analyses, including Tolkien’s. I address the roles of doctrine, ritual, cross-cultural patterns, mythic expressions in literature, the literary effect of myth, evolution of language and consciousness, and individual invention over inheritance and diffusion. Beyond Tolkien’s English and Catholic background, I argue for eclectic influence on Tolkien, including resonance with Buddhism. Tolkien views mythopoeia, literary mythmaking, in terms of sub-creation, human invention in the image of God as creator. Key mythopoetic tools include eucatastrophe, the happy ending’s sudden turn to poignant joy, and enchantment, the realization of imagined wonder, which is epitomized by the character of Tom Bombadil and contrasted with modernist techno-magic seeking to alter and dominate the world. I conclude by interpreting Tolkien’s mythmaking as a form of mysticism.

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.