Visual management system to improve care planning and controlling: the case of intensive care unit

Health Lean Management (HLM) is usually implemented to enhance the operational performance in health care; nevertheless, scant attention is devoted to visual control and daily accountability processes. This paper aims at investigating how to adopt a visual management system to: plan and control patient journey in health care operations and perform a continuous improvement process. Conducting in-depth interviews and observations, participating in meetings and collecting documentation, the patient journey board and daily briefings of an Intensive Care Unit were studied and improved. In the patient journey board, the Plan, Do and Check phases were reported, distinguishing between actual and planned actions for the patient care. The daily meetings were organised and a continuous improvement board was also developed to solve specific issues (Act phase), by creating ad-hoc teams, involving the staff and reporting transparently on the board. Operational and sociotechnical performance, before and after the adoption of HLM, were assessed demonstrating the effectiveness and efficiency of visual management tools.     

How to reconsider risk management in SMEs? An Advanced,Reasoned and Organised Literature Review

The purpose of this paper is two-fold: to reconsider the fundamental role of risk management (RM) in small and medium enterprises (SMEs) by identifying and critically analysing the most important international works; and to define opportunities for further studies by suggesting a different approach to study the topic. This research is based on a new hybrid method developed by the authors, called Advanced, Reasoned and Organised (ARO) literature review, which improves the quality of literature reviews by integrating the systematic review for quantitative papers, the meta-synthesis for qualitative research and the critical interpretative analysis. Forty-eight articles were included in the literature review. Bibliometric and cluster analyses were carried out. Two hypotheses were applied as filters in the interpretative synthesis of the content and guided the analysis to answer two research questions. The findings underline that RM in SMEs is still a ‘spot’ subject as they put little effort into the risk identification, assessment and monitoring. The lack of procedures and strategies is due to the lack of risk mindfulness and knowledge, and it is related to the managers’ and owners’ risk attitudes. It is fundamental to understand why risk procedures are not implemented and to find a way to raise awareness of the potential benefits of risk and control measures. The topic is current, and the multidisciplinary perspective and mixed-method approach enhance both theoretical and practical contributions for academics and SME owners.     

Does self-efficacy matter for burnout and sickness absenteeism? The mediating role of demands and resources at the individual and team levels

In team-based organizations, team members may share similar experiences, feelings and, consequently, susceptibility to burnout. This study explores the burnout process beyond the individual level of analysis and integrates Social Cognitive Theory (SCT) with the Job Demands-Resources Model (JD-R), emphasizing the role of self-efficacy in shaping the meaning that people ascribe to situations. A multilevel structural equation model was tested in which it was predicted that work self-efficacy beliefs would be associated with burnout both directly and indirectly via job demands and job resources, and at both the individual and the team level. Moreover, it was posited that, at the team level, registered sickness absences are predicted by burnout. A sample of 5406 call centre operators, clustered in 186 teams working in the same large Italian company, filled out a questionnaire, whereas team absence rates were provided by the company's HR department. The findings largely supported the hypothesized model: at both levels, job demands and job resources partially mediated the relationship between self-efficacy and burnout. Moreover, at the team level, burnout predicted subsequent sickness absenteeism. In addition, individual-level burnout was primarily associated with job demands, whereas team-level burnout was primarily associated with a lack of team-level resources.     

International Migration and Gender in Latin America: A Comparative Analysis

We review census data to assess the standing of five Latin American nations on a gender continuum ranging from patriarchal to matrifocal. We show that Mexico and Costa Rica lie close to one another with a highly patriarchal system of gender relations whereas Nicaragua and the Dominican Republic are similar in having a matrifocal system. Puerto Rico occupies a middle position, blending characteristics of both systems. These differences yield different patterns of female relative to male migration. Female householders in the two patriarchal settings displayed low rates of out-migration compared with males, whereas in the two matrifocal countries the ratio of female to male migration was much higher, in some case exceeding their male counterparts. Multivariate analyses showed that in patriarchal societies, a formal or informal union with a male dramatically lowers the odds of female out-migration, whereas in matrifocal societies marriage and cohabitation have no real effect. The most important determinants of female migration from patriarchal settings are the migrant status of the husband or partner, having relatives in the United States, and the possession of legal documents. In matrifocal settings, however, female migration is less related to the possession of documents, partner's migrant status, or having relatives in the United States and more strongly related to the woman's own migratory experience. Whereas the process of cumulative causation appears to be driven largely by men in patriarchal societies, it is women who dominate the process in matrifocal settings.     

Contrast function estimation for the drift parameter of ergodic jump diffusion process

In this paper, we consider an ergodic diffusion process with jumps whose drift coefficient depends on an unknown parameter. We suppose that the process is discretely observed. We introduce an estimator based on a contrast function, which is efficient without requiring any conditions on the rate at which the step discretization goes to zero, and where we allow the observed process to have nonsummable jumps. This extends earlier results where the condition on the step discretization was needed and where the process was supposed to have summable jumps. In general situations, our contrast function is not explicit and one has to resort to some approximation. In the case of a finite jump activity, we propose explicit approximations of the contrast function such that the efficient estimation of the drift parameter is feasible. This extends the results obtained by Kessler in the case of continuous processes.     

Group Interventions for Children Having Separated Parents: A Systematic Narrative Review

The aims of this article are to review the current body of knowledge on group interventions for children with separated or divorced parents and to provide new insights into the evaluation of their efficacy. This review draws on a method of systematic narrative review (SNR). We provide a narrative synthesis of evidence from 29 studies conducted between 1980 and 2014, which were included in the SNR consistently with the inclusion criteria established. Three dimensions were considered: intervention characteristics, study characteristics, and intervention outcomes (i.e., types of outcomes and efficacy). Our findings showed a general inconsistency among the studies, which was discussed in the light of some important methodological issues.     

The identity and professional culture of the educator at the beginning of the university path in Italy

To work as an educator in Italy has required a specific university degree for only a few years now. This change has institutionalized the educational path regarding some factual knowledge and skills. However, the profession of educator also relates to an experiential culture and to personal motivations affecting and sustaining each individual's choice of the profession. This paper examines the ideas of professional identity held by a group of Italian students at the beginning of their college career. The sample includes two groups at the University of Padua, one group learning to work in social work, one group learning to work in health care. During the first three years of the new academic requirement, first-year students in both groups were qualitatively and quantitatively surveyed. In particular the study explores the reasons students orient towards these curricula, and the distinctive elements, competences, experiences and values they include in their image of an educator. Statistical multi-dimensional methods of data analysis are used.     

Gender or Occupational Status: What Counts More for Well-Being at Work?

The aim of this study is to provide cross-cultural empirical support that endorses the scientific nature of Quality of Life (QoL), which a review of definitions reveals as a nomothetic and multidimensional concept (personal and environmental circumstances), made up of a set of subjective and objective indicators. Although this is commonly accepted, many instruments and authors reduce it to subjective and personal conditions. Bearing in mind the aim described, multi-group Structural Equation Modelling analysis was applied to two representative samples made up of 1217 participants aged over 60 from Mexico and Spain, recruited both at random (through the random route procedure), who completed the CUBRECAVI (Brief Questionnaire of Quality of Life). In this model two third-order latent variables are considered for QoL: personal and external factors, both made up of objective and subjective indicators. As predicted, the results permit us to state that the structural model is invariant across the two countries—that is, although the QoL construct has the same structure in the two countries, the importance of the indicators (factor loadings) and the relationships between them are not equivalent.     

Invasive weeds in urban riparian zones: the influence of catchment imperviousness and soil chemistry across an urbanization gradient

The riparian zones of urban waterways are frequently degraded by weed invasions. This study examined the effects of different levels of catchment imperviousness, as a surrogate for the extent and intensity of urbanisation, on invasive weeds and soil physical and chemical attributes. The study was conducted adjacent to waterways in the partly urbanised Georges River catchment in south western Sydney. Vegetation and soil sampling was undertaken in the riparian zone of 10 freshwater streams in non-urban (low imperviousness), peri-urban (moderate imperviousness) and urban (high imperviousness) sub-catchments. Soil samples were tested for a suite of physical and chemical properties (moisture, bulk density, organic matter, pH, salinity, phosphorus, potassium and calcium). Increased levels of sub-catchment imperviousness and urbanisation were associated with higher weed coverage and elevated soil geochemical attributes. One of the most interesting findings in this study was that urban soil calcium concentrations were over 2000 times greater than soils collected from non-urban catchments. The BIOENV procedure identified soil pH, salinity, calcium, organic matter, moisture and catchment imperviousness to be important environmental factors associated with variation in riparian vegetation. The single factor of soil pH was most highly correlated with variations in riparian vegetation. Soil pH was approximately 1.5 units higher in urban compared to non-urban riparian soils. We speculate that there is a link between urban concrete materials, urban soil and water contaminants and riparian weed invasion. We also recommend further study into the contribution of urban concrete materials on the geochemical contamination of riparian soils.     

Immigrant groups’ income inequality within and across Italian regions

The relationship between Italian regional income inequality and the phenomenon of migration is still under current debate. Policymakers and researchers worry about the process of assimilation of the new entrants, in a country where regional disparities are strong. We provide evidence that regional income disparities apply to groups of immigrants as well as of nationals, but the most important source of inequality rests on within-immigrant group/within-region, especially for those households with the presence of women and very young children. However, if bottom incomes were to grow, inequality would not diminish, with the exception of married individuals living in the North, for no other characteristic is correlated to inequality according to the Atkinson bottom sensitive index. We show that the uneven economic development across regions then influences the distribution of immigration both in sociodemographic and economic terms.