A new value stream mapping approach for healthcare environments

Hospitals worldwide are giving a growing emphasis to the application of lean concepts in the healthcare sector, commonly known as ‘lean healthcare’. A fundamental tool that allows such implementations is the value stream mapping (VSM). The problem is that VSM models used in implementations of lean healthcare are simple adaptations of the original VSM model, which was initially directed towards manufacturing and may not always represent important support activities for the patient flow that directly impact treatment time. Within this context, this paper presents a new VSM approach for healthcare environments. This new VSM model, specifically designed for healthcare environments, contemplates all activities that directly affect the treatment time. In addition, the present paper also presents an action research in a Brazilian hospital where the proposed VSM model is compared to other VSM models found in the literature. The results shown that the proposed VSM model was able to identify some operational bottlenecks and wastes that interfere in the patient’s treatment that could not be identified by other mapping models studied.     

Organizational status growth and structure: An alliance network analysis

Considering the status system emerging from a structure of corporate affiliations, we examine how alliance patterns among firms affect their changing organizational statuses and the structural development of the status system itself. Firm status is conceptually grounded in sociological theories of status and network analysis. The empirical setting we investigate is the network of alliances among firms in the Global Information Sector. The results indicate a negative effect of initial firm status on the growth rate of individual status, which is associated with the different patterns of alliance affiliations among firms with different status levels. Affiliation patterns also affect the extent of variation in the gap between status strata and firm mobility along the status hierarchy. The results highlight the importance of understanding the structural aspects underlying firm status attainment.     

Moving Fragments

This article examines three films as they wrestle with the problem of madness through the construction of narrative: Grizzly Man (Director, Werner Herzog, 2005), Capturing the Friedmans (Director, Andrew Jarecki, 2003), and Tarnation (Director, Jonathan Caouette, 2003). There is progression in the narrative capacities depicted and enacted in each film: from the representation of a boundary with the unsymbolizable, through the failed figuration of sexuality, to the realization of a self-reflexive and thus transformational narrative. Working at the intersection of the personal and the social, the article postulates that films can serve as social containers for the elaboration of narratives that allow subjective cultural intelligibility. We are transformed through viewership. Specifically, the relatively new use of videography as a means of recording and shaping life experience creates novel forms of personal narrative that function as social containers. Narratives of personal madness are seen to constitute the true residence of sanity.     

Ethnic Labels and Ethnic Identity as Predictors of Drug Use among Middle School Students in the Southwest

This article explores differences in the self‐reported drug use and exposure to drugs of an ethnically diverse group of 408 seventh‐grade students from a large city in the southwest. We contrast the explanatory power of ethnic labels (African American, non‐Hispanic White, Mexican American, and mixed ethnicity) and two dimensions of ethnic identity in predicting drug use. One dimension focuses on perceived ethnically consistent behavior, speech, and looks, while the other gauges a sense of ethnic pride. Ethnic labels were found to be somewhat useful in identifying differences in drug use, but the two ethnic identity measures, by themselves, did not generally help to explain differences in drug use. In conjunction, however, ethnic labels and ethnic identity measures explained far more of the differences in drug use than either did alone. The findings indicate that the two dimensions of ethnic identity predict drug outcomes in opposite ways, and these relations are different for minority students and non‐Hispanic White students. Generally, African American, Mexican American, and mixed‐ethnicity students with a strong sense of ethnic pride reported less drug use and exposure, while ethnically proud White students reported more. Ethnic minority students who viewed their behavior, speech, and looks as consistent with their ethnic group reported more drug use and exposure, while their White counterparts reported less. These findings are discussed, and recommendations for future research are provided.     

Educational potential of e-social work: social work training in Spain

ABSTRACT

Information and communication technologies (ICTs) have enhanced peer communication and contributed to social change and, as such, have become an essential tool in the initial training and professional development of future social work practitioners. In the new millennium, it is particularly important to provide the foundations for delivering appropriate interventions in the fields of social education, social services, healthcare and development cooperation. To face these new challenges, training programmes in the framework of the European Higher Education Area should facilitate the acquisition of skills and competencies through curricula based on ongoing assessment which promote creativity and educational innovation. Through a systematic and comprehensive review of the scientific literature, this article examines the educational potential of e-social work in Spain and the training needs of social workers from an interdisciplinary approach. A critical debate is presented throughout the paper to encourage reflection among professionals. The study highlights the importance of the acquisition of digital skills through the development of educational intervention programmes using the latest technological media and resources with a view to serving citizens in these new spaces of interaction.     

Solving Steiner Tree Problems in Graphs with Lagrangian Relaxation

This paper presents an algorithm to obtain near optimal solutions for the Steiner tree problem in graphs. It is based on a Lagrangian relaxation of a multi-commodity flow formulation of the problem. An extension of the subgradient algorithm, the volume algorithm, has been used to obtain lower bounds and to estimate primal solutions. It was possible to solve several difficult instances from the literature to proven optimality without branching. Computational results are reported for problems drawn from the SteinLib library.     

Learning the Wealth of Nations

We study the evolution of market‐oriented policies over time and across countries. We consider a model in which own and neighbors' past experiences influence policy choices through their effect on policymakers' beliefs. We estimate the model using a large panel of countries and find that it fits a large fraction of the policy choices observed in the postwar data, including the slow adoption of liberal policies. Our model also predicts that there would be reversals to state intervention if nowadays the world was hit by a shock of the size of the Great Depression.     

Does the presence of independent and female directors impact firm performance? A multi-country study of board diversity

This study empirically analyzes whether gender diversity enhances boards of directors’ independence and efficiency. Using data from 3,876 public firms in 47 countries and controlling for a wide set of corporate governance mechanisms, we find that firms with more female directors have higher firm performance by market (Tobin’s Q) and accounting (return on assets) measures. The results also suggest that external independent directors do not contribute to firm performance unless the board is gender diversified. These results hold with respect to different estimation models and robustness tests. Overall, our findings provide evidence that the female directors enhance boards of directors’ effectiveness. Finally, we find that firms that are concerned with board independence, and that firms in more complex environments are more likely to have gender-balanced boards.     

On beta regression residuals

We propose two new residuals for the class of beta regression models, and numerically evaluate their behaviour relative to the residuals proposed by Ferrari and Cribari-Neto. Monte Carlo simulation results and empirical applications using real and simulated data are provided. The results favour one of the residuals we propose.