Technical efficiency in primary health care: does quality matter?

The accuracy required in the measurement of output is an issue that has as yet still not been satisfactorily addressed in empirical research on efficiency in primary health care. We exploit information retrieved from a newly constructed database (APEX06) for the Spanish region of Extremadura. The richness of our dataset allows us to consider original synthetic measures of output that take into account both the quantity and the quality of services provided by 85 primary care centres (PCCs) in 2006. We provide evidence that neglecting the issue of properly accounting for the quality of health services can lead to misleading results. Our main finding is that adjusting output for quality influences efficiency analysis in three senses. First, inefficiency now explains relatively more of the deviation from the potential output. Second, the average technical efficiency in the sector is lower, while its dispersion among PCCs is significantly higher. And third, the efficiency ranking of the PCCs is also affected.Primary Health Care; Stochastic Frontier Analysis; Technical Efficiency; Quality

The Use of Parametric and Non Parametric Frontier Methods to Measure the Productive Efficiency in the Industrial Sector. A Comparative Study

Parametric frontier models and non-parametric methods have monopolised the recent literature on productive efficiency measurement. Empirical applications have usually dealt with either one or the other group of techniques. This paper applies a range of both types of approaches to an industrial organisation setup. The joint use can improve the accuracy of both, although some methodological difficulties can arise. The robustness of different methods in ranking productive units allows us to make an comparative analysis of them. Empirical results concern productive and market demand structure, returns-to-scale, and productive inefficiency sources. The techniques are illustrated using data from the US electric power industry.Productive efficiency; parametric frontiers; DEA; industrial sector

Supercritical super-Brownian motion with a general branching mechanism and travelling waves

We consider the classical problem of existence, uniqueness and asymptotics of monotone solutions to the travelling wave equation associated to the parabolic semi-group equation of a super-Brownian motion with a general branching mechanism. Whilst we are strongly guided by the probabilistic reasoning of Kyprianou (2004) for branching Brownian motion, the current paper offers a number of new insights. Our analysis incorporates the role of Seneta-Heyde norming which, in the current setting, draws on classical work of Grey (1974). We give a pathwise explanation of Evans' immortal particle picture (the spine decomposition) which uses the Dynkin-Kuznetsov N-measure as a key ingredient. Moreover, in the spirit of Neveu's stopping lines we make repeated use of Dynkin's exit measures. Additional complications arise from the general nature of the branching mechanism. As a consequence of the analysis we also offer an exact X(log X)^2 moment dichotomy for the almost sure convergence of the so-called derivative martingale at its critical parameter to a non-trivial limit. This differs to the case of branching Brownian motion and branching random walk where a moment `gap' appears in the necessary and sufficient conditions.Comment: 34 page

Ecosystemic Services Linked to Water and Plant diversity of the San José de Chazo-Santa Fe de Galán Region

In the higher part of the Santa Fe de Galán parish, intensive agricultural activities are carried out that cause problems of erosion, disappearance of species of fauna and flora, decrease in water and deterioration of páramo areas due to the advance of the agricultural frontier. These activities present a threat to the sustainability of the San José de Chazo-Santa Fe de Galán region, due to the degradation of its natural resources that directly affect the vital development of 1200 families belonging to this region. The present investigation aims to study ecosystem services linked to water, as well as floristic diversity, for which data was collected and systematized from the Ciénega páramo in the San José de Chazo-Santa Fe de Galán region. According to the data collected on floristic diversity, 29 samples of terrestrial vascular plants were registered, corresponding to 18 families, 26 genera and 29 species; moss and lichen of unidentified family, genus and species were also collected. The highest index of importance value by species and family was presented by the moss with 20.39% and 18.17%, respectively. The average monthly flow during the February–May period observed through the volumetric method was 6.34 L/s. Keywords: capacity, flow, diversity, paramo, ecosystem services, sustainability. Resumen En la parte alta de la Parroquia Santa Fe de Galán se desarrollan actividades agropecuarias intensivas que provocan problemas de erosión, desaparición de especies de fauna y flora, disminución del agua y deterioro de áreas de páramo por el avance de la frontera agrícola. Estas actividades representan una amenaza para la sostenibilidad de la Regional San José de Chazo– Santa Fe de Galán, debido a la degradación de sus recursos naturales que inciden directamente en el desarrollo vital de 1200 familias pertenecientes a esta Regional. La presente investigación tiene como objetivo estudiar los servicios ecosistémicos ligados al agua y diversidad florística, cuyos datos fueron recolectados y sistematizados del páramo de la Ciénega en la Regional San José de Chazo–Santa Fe de Galán. De acuerdo con los resultados de diversidad florística se registró 29 muestras de plantas vasculares terrestres, correspondiente a 18 familias, 26 géneros y 29 especies, también se recolectó musgo y liquen de familia, género y especie no identificados. El mayor índice de valor de importancia por especie y familia lo presentó el musgo con 20,39% y 18,17%, respectivamente. El caudal promedio mensual durante el período febrero – mayo a través del método volumétrico fue de 6,34 L/s. Palabras clave: aforo, caudal, diversidad, páramo, servicios ecosistémicos, sostenibilidad

Magnetization Process of High Anisotropy Copt Nanosized Dots

The magnetization reversal process of the CoPt dot was investigated in this paper. It was observed that the magnetization reversal of the dot was initiated by the rotation process of a nucleus with the volume of (17 nm)/sup 3/

Un tiempo y un lugar para marcar diferencias

SEFAC celebra este año en mayo el VI Congreso Nacional de Farmacéuticos Comunitarios (www.congresosefac2014.org) con el reto de continuar creciendo y demostrar con hechos la importancia que tiene la labor del farmacéutico para mejorar el funcionamiento del sistema sanitario. El lugar escogido para la cita es Málaga, donde todos los que defendemos el valor asistencial de la farmacia comunitaria tenemos una cita imprescindible, pues se esperan más de mil asistentes procedentes de toda España e incluso de otros países

Comparative in vitro evaluation of contact activity of fluralaner, spinosad, phoxim, propoxur, permethrin and deltamethrin against the northern fowl mite, Ornithonyssus sylviarum.

BackgroundNorthern fowl mites (Ornithonyssus sylviarum) are obligate hematophagous ectoparasites of both feral birds and poultry, particularly chicken layers and breeders. They complete their entire life-cycle on infested birds while feeding on blood. Infestations of O. sylviarum are difficult to control and resistance to some chemical classes of acaricides is a growing concern. The contact susceptibility of O. sylviarum to a new active ingredient, fluralaner, was evaluated, as well as other compounds representative of the main chemical classes commonly used to control poultry mite infestations in Europe and the USA.MethodsSix acaricides (fluralaner, spinosad, phoxim, propoxur, permethrin, deltamethrin) were dissolved and serially diluted in butanol:olive oil (1:1) to obtain test solutions used for impregnation of filter paper packets. A carrier-only control was included. Thirty adult northern fowl mites, freshly collected from untreated host chickens, were inserted into each packet for continuous compound exposure. Mite mortality was assessed after incubation of the test packets for 48 h at 75% relative humidity and a temperature of 22 °C.ResultsAdult mite LC50 /LC99 values were 2.95/8.09 ppm for fluralaner, 1587/3123 ppm for spinosad, 420/750 ppm for phoxim and 86/181 ppm for propoxur. Permethrin and deltamethrin LC values could not be calculated due to lack of mortality observed even at 1000 ppm.ConclusionsNorthern fowl mites were highly sensitive to fluralaner after contact exposure. They were moderately sensitive to phoxim and propoxur, and less sensitive to spinosad. Furthermore, the tested mite population appeared to be resistant to the pyrethroids, permethrin and deltamethrin, despite not being exposed to acaricides for at least 10 years

Anomalous Hall-effect measurement study on Co/Pt nanosized dot

Dot arrays made of polycrystalline Co/Pt multilayer with an average grain size of 20 nm are fabricated by using a laser interference lithography and their magnetic properties are examined by detecting anomalous Hall effect. It is revealed that the ratio of dots which have stable single domain state increases from 35% to 85% while the dot diameter decreased from 200 to 120 nm. The energy barrier height of magnetization reversal is estimated as 4.0 10-12 erg from sweep rate dependence of the coercivity. The energy corresponds to the switching volume comparable with the volume of a physical grain in the multilayer film

Relationships between algal food and gut and gonad conditions in the Mediterranean sea urchin Paracentrotus lividus (Lam.)

A study was conducted on the population of Paracentrotus lividus (Lamarck, 1816) in a Mediterranean infralittoral bottomof southern of Spain to characterize the relationships between the macroalgal food ingested and the gut and gonad conditions of individuals. Over a full annual cycle (November 2008 to October 2009) composition of the gut content was analyzed monthly and seasonally, the gastrointestinal (GII), repletion (RI) and gonadosomatic (gonad) (GI) indices were calculated, and the stage of gonad maturity of the population was assessed. The GII and RI were found to be strongly correlated, so only the RI was considered in the subsequent analysis. The prevalence of Phaeophyceae and local species of this macroalgal group in the gut content of the sea urchins throughout the year suggests that in conditions of abundant resources, with high levels of algal diversity and no effective limits on supply, brown algae are the main component of the natural diet of P. lividus. Comparison of the physiologicalindices and the algal fractions of gut content identified relationships throughout the year between RI, the stage of gonad maturity and GI. Specifically, these indices were found to be associated with the abundance of Rhodophyta ingested, although in different ways: GI was related to the consumption of fleshy (non-calcified) red algae and the RI, though less statistically significantly, to the consumption of calcified (articulate and encrusting)