Horizontal Collaborative e-Purchasing for Hospitals: IT for Addressing Collaborative Purchasing Impediments

Horizontal collaborative purchasing (HCP) has often been cited as a way for hospitals to address the challenges of the rising healthcare costs. However, hospitals do not seem to utilize horizontal collaborative purchasing on any large scale, and recent initiatives have had mixed results. Focusing on Dutch hospitals, in this paper we present major impediments for collaborative purchasing, resulting in a first component of our proposed electronic horizontal collaborative purchasing model for hospitals; as a second component it contains a collaborative purchasing typology. A first validation round with hospital purchasing professionals, described separately in Kusters and Versendaal (2011), confirmed four applicable purchasing types and fourteen salient collaborative purchasing impediments. The model is operationalized by including possible information technology (IT) solutions that address the specific fourteen impediments. This model is validated through methodological triangulation of four different validation techniques. We conclude that IT has the potential to support, or overcome, the impediments of HCP. The validation also reveals the need to distinguish between more process-related, as opposed to social-related, obstacles; the immediate potential for IT solutions is greater for the process-related impediments. Ultimately, we conclude that the collaborative e-purchasing model (e-HCP) and implementation roadmap can be used by healthcare consortia, branche organizations, partnering healthcare institutes and multi-site healthcare institutes as a means to help identifying strategies to initiate, manage and evaluate collaborative purchasing practices

Формування індивідуального стилю у творчості народних майстрів художньої обробки дерева (на прикладі різьбярських династій Шкрібляків та Корпанюків)

У статті розглянуто творчість видатних різьбярських династій Шкрібляків та Корпанюків з позиції формування власного стилю в кожного з майстрів та їхнього впливу на зародження Косівської школи художньої обробки дерева. Особливу увагу приділено тим технічним і технологічним новаціям, які застосовували у своїх творах різьбярі, та тим композиційним прийомам, які вирізняли їхні вироби з-поміж інших.В статье рассматривается творчество выдающихся династий резчиков Шкрибляков и Корпанюков с точки зрения формирования собственного стиля у каждого из мастеров и их влияния на зарождение Косовской школы художественной обработки дерева. Особое внимание уделяется тем техническим и технологическим новациям, которые использовали резчики в своих произведениях, и композиционным приёмам, выделяющим их изделия среди прочих.There is an observation of creative work of the illustrious Shkribliak and K orpaniuk houses of carvers from a position of formation of a master’s individual style and proceeding from each master’s impact on the K osiv artistic carving school’s origin. The author pays a specific attention to the technical and technological innovations which are put into practice by a carver as well as to the composition wethods which differ carver’s wares from the rest

Double Exchange Alone Does Not Explain the Resistivity of La1−xSrxMnO3La_{1-x} Sr_x MnO_3

The $La_{1-x} Sr_x MnO_3$ system with $0.2 \lesssim x \lesssim 0.4$ has traditionally been modelled with a ``double exchange'' Hamiltonian, in which it is assumed that the only relevant physics is the tendency of carrier hopping to line up neighboring spins. We present a solution of the double exchange model, show it is incompatible with many aspects of the resistivity data, and propose that a strong electron-phonon interaction arising from a Jahn-Teller splitting of the outer Mn d-level plays a crucial role.Comment: Figure available via concentional mail. Contact [email protected]

Realization of the farad from the dc quantum Hall effect with digitally-assisted impedance bridges

A new traceability chain for the derivation of the farad from dc quantum Hall effect has been implemented at INRIM. Main components of the chain are two new coaxial transformer bridges: a resistance ratio bridge, and a quadrature bridge, both operating at 1541 Hz. The bridges are energized and controlled with a polyphase direct-digital-synthesizer, which permits to achieve both main and auxiliary equilibria in an automated way; the bridges and do not include any variable inductive divider or variable impedance box. The relative uncertainty in the realization of the farad, at the level of 1000 pF, is estimated to be 64E-9. A first verification of the realization is given by a comparison with the maintained national capacitance standard, where an agreement between measurements within their relative combined uncertainty of 420E-9 is obtained.Comment: 15 pages, 11 figures, 3 table

Double Degeneracy and Jahn-Teller Effects in CMR Perovskites

Jahn-Teller (JT) electron-phonon coupling effects in the colossal magnetoresistance perovskite compounds $La_{1-x}A_xMnO_3$ are investigated. Electron-electron correlations between two degenerate Mn $e_g$ orbitals are studied in the Gutzwiller approximation. The static JT distortion and antiadiabatic polaron effects are studied in a modified Lang-Firsov approximation. We find that (i) the electron or hole character of the charge carrier depends on the static JT distortion, and (ii) due to the two-component nature of the JT coupling, fluctuations in the JT distortion direction contribute to the charge transport in similar fashion as the local spins.Comment: 11 RevTeX pages. 3 Figures available upon request. submitted to Phys. rev. B (Rapid Communications

Impact of Charge Ordering on Magnetic Correlations in Perovskite (Bi,Ca)MnO_3

Single crystalline (Bi,Ca)MnO3 (74< %Ca <82) were studied with neutron scattering, electron diffraction and bulk magnetic measurement. We discovered dynamic ferromagnetic spin correlations at high temperatures, which are replaced by antiferromagnetic spin fluctuations at a concomitant charge ordering and structural transition. Our results indicate that thermal-activated hopping of the Jahn-Teller active e_g electrons in these insulating materials, nevertheless, induce ferromagnetic interaction through double-exchange mechanism. It is the ordering of these charges competing with the double-exchange ferromagnetic metallic state.Comment: 11 pages, 3 figures, Revte

Onderzoek naar de energetische waarde van monsters saucijzebroodjes en boterhamworst

In februari 1988 werden 26 monsters saucijzebroodjes en 27 monsters boterhamworst onderzocht op de gehalten aan vocht en vet. Met behulp van deze gehalten werden de energetische waarden van de monsters berekend. De gemiddelde energetische waarde van de monsters saucijzebroodjes was 1622 kJ/100 g, die van boterhamworst 1266 kJ/100 g. Vergelijking van de waarden van de boterhamworst met die van een in 1982 uitgevoerd onderzoek leert dat de gemiddelde energetische waarde van boterhamworst sinds 1982 met 12,5% is gedaald

Photoinduced IR absorption in (La(1-x)Sr(x)Mn)(1-\delta)O3: changes of the anti-Jahn-Teller polaron binding energy with doping

Photoinduced IR absorption was measured in (La(1-x)Sr(x)Mn)(1-\delta)O3. A midinfrared peak centered at ~ 5000 cm$^{-1}$ was observed in the x=0 antiferromagnetic sample. The peak diminishes and softens as hole doping is increased. The origin of the photoinduced absorption peak is atributted to the photon assisted hopping of anti-Jahn-Teller polarons formed by photoexcited charge carriers, whose binding energy decreases with increasing hole doping. The shape of the peak indicates that the polarons are small.Comment: 5 pages, 3 figures, submitted to PR

Dynamical Mean-Field Solution for a Model of Metal-Insulator Transitions in Moderately Doped Manganites

We propose that a specific spatial configuration of lattice sites that energetically favor {\it 3+} or {\it 4+} Mn ions in moderately doped manganites constitutes approximately a spatially random two-energy-level system. Such an effect results in a mechanism of metal-insulator transitions that appears to be different from both the Anderson transition and the Mott-Hubbard transition. Correspondingly, a disordered Kondo lattice model is put forward, whose dynamical mean-field solution agrees reasonably with experiments.Comment: 4 pages, 2 eps figures, Revtex. First submitted to PRL on May 16, 199