Efficiency and Technological Change in Health Care Services in Ontario

This paper presents productivity measurement results for hospital services using panel data for Ontario hospitals between 2003 and 2006. The study uses the Malmquist Productivity index (MPI) obtained through the application of Data Envelopment Analysis (DEA) which is decomposed into efficiency change (ECH), i.e., movement towards the best practice frontier and technological change (TCH), i.e., movement of the frontier itself (Färe et al. [12]). The study also uses kernel density estimation techniques for analysis of efficiency distributions of the productivity scores and their components across different types of hospitals (e.g. small /large and rural /urban) and over time. Our results suggest that in addition to average productivity it is important to examine distributions of productivity and of its components which we find differs by hospital type and over time. We find that productivity growth occurred mostly through improvement in technology and in spite of declining efficiency. The results provide useful insight into the underlying mechanisms of observed changes in overall productivity, in technological change and in technical efficiency change in this vital sector of the health care market.

HIV prevention in prisons: Do international guidelines matter?

Background: In spite of the availability of international guidelines, HIV prevention and management of care in prison is still unsatisfactory in many countries. Factors affecting the quality of HIV prevention policies in prison have not yet been elucidated. The present study had two aims: i) to assess national HIV prevention policies in prison in a selected group of countries; and ii) to determine which factors influenced such policies at the country level. Methods: HIV prevention policies in prison were reviewed comparatively in Moldova, Hungary, Nizhnii Novgorod region of the Russian Federation, Switzerland and Italy. The review of HIV prevention policies in prison was conducted through interviews with government officials, non‐governmental organizations, professionals involved in this field, and visits to selected prisons. Information on the health of prisoners, including tuberculosis, sexually transmitted diseases, and other infectious diseases has also been collected. Results: The results indicated that all countries had adopted a policy, irrespective of the burden of HIV infection in the prison system. The content of the policy mirrored the philosophy and strategies of HIV prevention and care in the community. The 1993 WHO Guidelines were fully implemented only in one country out of four (Switzerland), and partially in two (Italy and Hungary). Conclusions: A greater effort aimed at dissemination of information, provision of technical know‐how and material resources could be the answer to at least part of the problems identified. In addition, greater national and international efforts are needed to stimulate the debate and build consensus on harm reduction activities in priso

Mode boundaries of automated metro and semi-rapid rail in urban transit

The research question that we pose is to what extent, and under what circumstances, full automation in metro lines defines transit mode boundaries with respect to semirapid transit. The modeling approach that we follow is based on micro-economic appraisal. Automation, beside changing the investment and operation and maintenance cost profiles of metro lines, can improve some aspects of the user experience. The low marginal cost of frequency possible with automated metro may unlock both users' benefits via reduced waiting times and crowding, and operator's savings via shorter trains and smaller platforms and stations. We show how structurally different under several configurations are the user's travel time components. In particular, we highlight the critical role that different demand and alignment patterns play in the mode comparison

Dust in the reionization era: ALMA observations of a zz=8.38 Galaxy

We report on the detailed analysis of a gravitationally-lensed Y-band dropout, A2744_YD4, selected from deep Hubble Space Telescope imaging in the Frontier Field cluster Abell 2744. Band 7 observations with the Atacama Large Millimeter Array (ALMA) indicate the proximate detection of a significant 1mm continuum flux suggesting the presence of dust for a star-forming galaxy with a photometric redshift of $z\simeq8$. Deep X-SHOOTER spectra confirms the high redshift identity of A2744_YD4 via the detection of Lyman $\alpha$ emission at a redshift $z$=8.38. The association with the ALMA detection is confirmed by the presence of [OIII] 88$\mu$m emission at the same redshift. Although both emission features are only significant at the 4 $\sigma$ level, we argue their joint detection and the positional coincidence with a high redshift dropout in the HST images confirms the physical association. Analysis of the available photometric data and the modest gravitational magnification ($\mu\simeq2$) indicates A2744_YD4 has a stellar mass of $\sim$ 2$\times$10$^9$ M$_{\odot}$, a star formation rate of $\sim20$ M$_{\odot}$/yr and a dust mass of $\sim$6$\times$10$^{6}$ M$_{\odot}$. We discuss the implications of the formation of such a dust mass only $\simeq$200 Myr after the onset of cosmic reionisation.Comment: Accepted for publication in ApJ

Flexor digitorum brevis tendon transfer to the flexor digitorum longus tendon according to Valtin in posttraumatic flexible claw toe deformity due to extrinsic toe flexor shortening

AbstractClaw toe deformity after posterior leg compartment syndrome is rare but incapacitating. When the mechanism is flexor digitorum longus (FDL) shortening due to ischemic contracture of the muscle after posterior leg syndrome, a good treatment option is the Valtin procedure in which the flexor digitorum brevis (FDB) is transferred to the FDL after FDL tenotomy. The Valtin procedure reduces the deformity by lengthening and reactivating the FDL. Here, we report the outcomes of FDB to FDL transfer according to Valtin in 10 patients with posttraumatic claw toe deformity treated a mean of 34 months after the injury. Toe flexion was restored in all 10 patients, with no claw toe deformity even during dorsiflexion of the ankle

Dynamic routing problems with fruitful regions: models and evolutionary computation

We introduce the concept of fruitful regions in a dynamic routing context: regions that have a high potential of generating loads to be transported. The objective is to maximise the number of loads transported, while keeping to capacity and time constraints. Loads arrive while the problem is being solved, which makes it a real-time routing problem. The solver is a self-adaptive evolutionary algorithm that ensures feasible solutions at all times. We investigate under what conditions the exploration of fruitful regions improves the effectiveness of the evolutionary algorith

A zeta function approach to the relation between the numbers of symmetry planes and axes of a polytope

A derivation of the Ces\`aro-Fedorov relation from the Selberg trace formula on an orbifolded 2-sphere is elaborated and extended to higher dimensions using the known heat-kernel coefficients for manifolds with piecewise-linear boundaries. Several results are obtained that relate the coefficients, $b_i$, in the Shephard-Todd polynomial to the geometry of the fundamental domain. For the 3-sphere we show that $b_4$ is given by the ratio of the volume of the fundamental tetrahedron to its Schl\"afli reciprocal.Comment: Plain TeX, 26 pages (eqn. (86) corrected

Inertialess multilayer film flow with surfactant: Stability and traveling waves

Multilayer film flow down an inclined plane in the presence of an insoluble surfactant is investigated with particular emphasis on determining flow stability and investigating the possibility of traveling-wave solutions. The investigation is conducted for two or three layers under conditions of Stokes flow and, separately, on the basis of a long-wave assumption. A normal mode linear stability analysis for Stokes flow shows that adding surfactant to one of the film surfaces can destabilize an otherwise stable flow configuration. For the long-wave system, periodic traveling-wave branches are detected and traced, revealing solutions with pulselike solitary waves on each film surface traveling in phase with each other, traveling waves with capillary ridge structures, and solutions with two of the film surfaces almost in contact. Time-periodic traveling-wave solutions are also found. The stability of the traveling waves is determined by solving initial-value problems and by computing eigenvalue spectra. Boundary element simulations for Stokes flow confirm the existence of traveling waves outside the long-wave regime

The QCD string and the generalised wave equation

The equation for QCD string proposed earlier is reviewed. This equation appears when we examine the gonihedric string model and the corresponding transfer matrix. Arguing that string equation should have a generalized Dirac form we found the corresponding infinite-dimensional gamma matrices as a symmetric solution of the Majorana commutation relations. The generalized gamma matrices are anticommuting and guarantee unitarity of the theory at all orders of $v/c$. In the second quantized form the equation does not have unwanted ghost states in Fock space. In the absence of Casimir mass terms the spectrum reminds hydrogen exitations. On every mass level $r=2,4,..$ there are different charged particles with spin running from $j=1/2$ up to $j_{max}=r-1/2$, and the degeneracy is equal to $d_{r}=2r-1 = 2j_{max}$. This is in contrast with the exponential degeneracy in superstring theory.Comment: 11 pages LaTeX, uses lamuphys.sty and bibnorm.sty,; Based on talks given at the 6th Hellenic School and Workshop on Elementary Particle Physics, Corfu, Greece, September 19-26, 1998 and at the International Workshop "ISMP", Tbilisi, Georgia, September 12-18, 199