Identifying factors affecting about outsourcing in paraclinical services: a systematic review of literature

Objective: Outsourcing refers to the transfer of services or functions to an outsider supplier, which controls them through a contract or cooperative. The main problem of senior managers in health organizations is determining the services which should be outsourced. The present study seeks to identify the factors that affect decision about outsourcing.Methods: We systematically searched relevant databases including Pub Med, Scopus, Science Direct and Web of Science databases using terms “Outsourcing AND Decision Making OR Policy AND health OR hospital OR health care OR health services OR healthcare”. Studies were identified and screened in accordance with the preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) published in English or Farsi, determining factors that affect making decision about outsourcing a health organization services.Results: The search retrieved (2585) citation of which 14 studies were eligible. Across the eligible articles,10 overarching themes including 40subthemes that affectdecision maker to outsource a service or not, emerged.Conclusions: Results of this study offer evidence for a comprehensive approach todesign and implement a strategic planthat can be used as guidance for policy makers, micro and macro healthcare authorities and managers, and other stakeholders in this area to select and apply the best strategies to make outsourcing in the best possible way.Keywords: Outsourcing, Health Services, Effective factors, Health Organizatio

On the optimality of score-driven models

Score-driven models have been recently introduced as a general framework to specify time-varying parameters of conditional densities. %The underlying idea is to specify a time-varying parameter as an autoregressive process with innovation given by the score of the associated log-likelihood. The score enjoys stochastic properties that make these models easy to implement and convenient to apply in several contexts, ranging from biostatistics to finance. Score-driven parameter updates have been shown to be optimal in terms of locally reducing a local version of the Kullback–Leibler divergence between the true conditional density and the postulated density of the model. A key limitation of such an optimality property is that it holds only locally both in the parameter space and sample space, yielding to a definition of local Kullback–Leibler divergence that is in fact not a divergence measure. The current paper shows that score-driven updates satisfy stronger optimality properties that are based on a global definition of Kullback–Leibler divergence. In particular, it is shown that score-driven updates reduce the distance between the expected updated parameter and the pseudo-true parameter. Furthermore, depending on the conditional density and the scaling of the score, the optimality result can hold globally over the parameter space, which can be viewed as a generalization of the monotonicity property of the stochastic gradient descent scheme. Several examples illustrate how the results derived in the paper apply to specific models under different easy-to-check assumptions, and provide a formal method to select the link-function and the scaling of the score

Analysis of specific radionuclides activity variations in soil within geotectonic units of Republic of North Macedonia

To establish baseline values for concentrations of terrestrial radionuclides for the Republic of North Macedonia, a survey covering the entire territory was performed. The 213 soil samples were collected from regions around the major settlements and cities, approximately evenly distributed over the geotectonic units which constitute the country's geological foundation. The specific activities of radionuclides were measured by gamma spectrometry. The following geometric mean values and geometric standard deviations were obtained: 550 Bqkg(-1) (1.47) for K-40, (37) Bqkg(-1) (1.33) for Ra-226, 38 Bqkg(-1) for U-238, and 38 Bqkg(-1) (1.53) for Th-232 in dry soil. The relation between specific activities of natural radionuclides and geology was investigated. Correlation between radionuclides, which may serve as additional geochemical indicators, and geology could not be found convincingly,. Mutual correlations between Ra-226, U-238, and Th-232 activities were found to be high (Spearman rho about 0.8), whereas the ones between these and K-40 are a bit lower, somewhat above rho = 0.6

Residual strength assessment of cracked welded spherical storage tank

Dva sferna rezervoara za amonijak (zapremine 1000 m3) su ispitana 1998. i 1999. tehnikama bez razaranja (NDT) u skladu sa Propisima za periodičnu kontrolu. Ovi rezervoari su izrađeni 1979. od čelika StE 460 prema DIN, mikrolegiranog Cr-Ni-Ti, debljine 30 mm. Uočen je veliki broj poprečnih prslina u metalu šava i uzdužnih prslina u zoni-uticaja-toplote (ZUT) i po liniji stapanja unutrašnjih zavarenih spojeva. Da bi se procenila zaostala čvrstoća oba rezervoara, ploče 500 x 500 mm, su isečene radi hemijskog, metalurškog i mehaničkog ispitivanja. Ova ispitivanja su obuhvatala detaljno određivanje žilavosti standardnih Šarpi epruveta na instrumentiranom klatnu i ispitivanja mehanike loma na standardnim SEN(B) epruvetama za ocenu žilavosti loma. Na osnovu rezultata Šarpi ispitivanja i ispitivanja mehanike loma ocenjena je preostala čvrstoća sfernih rezervoara sa prslinama.Two spherical storage tanks for ammonia (volume 1000 m3) have been tested in 1998 and 1999 by Non-Destructive Techniques (NDT) in accordance with the Periodic Inspection Regulations. These storage tanks have been constructed in 1979 of St.E460 steel according DIN, Cr-Ni-Ti microalloyed, 30 mm thick. The large number of transverse cracks in weld metal and longitudinal cracks in heat-affected-zone (HAZ) and along fusion line of inner welded joints have been detected. In order to assess the residual strength, of both storage tanks, plates 500 x 500 mm were cut for chemical, metallurgical and mechanical testing. These testing included detailed toughness testing of standard Charpy specimens on instrumented pendulum, and fracture mechanics testing on standard SEN(B) specimens for fracture toughness evaluation. Based on results of Charpy and fracture mechanics testing residual strength of cracked storage tanks has been assessed