Ambulance allocation for maximal survival with heterogeneous outcome measures

This paper proposes new models for locating emergency medical services (EMS) by incorporating survival functions for capturing multiple-classes of heterogeneous patients. The Maximal Expected Survival Location Model for Heterogeneous Patients (MESLMHP) aims to maximize the overall expected survival probability of multiple-classes of patients, whereby different classes could be defined according to agreed patient categories based on response time targets, or by capturing differing medical conditions each with a corresponding survival function. Furthermore, we propose and demonstrate an approximation approach to solving the extended stochastic version of MESLMHP, which utilizes queuing theory to permit the modeling of congestion and utilization at each ambulance station, and does not require assumptions to be made on the utilization of ambulances. Both models are demonstrated using data from the ambulance service in Wales. We show that our multiple outcome measures and survival-maximizing approach, rather than one based on average response time targets alone or a single patient class provides more effective EMS ambulance allocations.     

International issues of the design and usage of websites for e-commerce: Hotel and airline examples

Technology has globalized businesses. International business is difficult due to differences in languages and cultures. In terms of technology, in some countries, it is difficult to get data; while in others, data is input in different ways. This paper examines how international differences affect website design, implementation and usage. We analyze websites of airlines and hotels. While some websites take into consideration language and culture differences, we find significant room for improvement in both industries. We found support for localization strategy in marketing, communication and transactions. Theoretical and practical implications, including language translators, currency converters and pull-down fields, are discussed.     

Improving Weight of Evidence Approaches to Chemical Evaluations

Federal and other regulatory agencies often use or claim to use a weight of evidence (WoE) approach in chemical evaluation. Their approaches to the use of WoE, however, differ significantly, rely heavily on subjective professional judgment, and merit improvement. We review uses of WoE approaches in key articles in the peer‐reviewed scientific literature, and find significant variations. We find that a hypothesis‐based WoE approach, developed by Lorenz Rhomberg et al., can provide a stronger scientific basis for chemical assessment while improving transparency and preserving the appropriate scope of professional judgment. Their approach, while still evolving, relies on the explicit specification of the hypothesized basis for using the information at hand to infer the ability of an agent to cause human health impacts or, more broadly, affect other endpoints of concern. We describe and endorse such a hypothesis‐based WoE approach to chemical evaluation.     

Decisions,Science, and Values: Crafting Regulatory Alternatives Analysis

Emerging “prevention‐based” approaches to chemical regulation seek to minimize the use of toxic chemicals by mandating or directly incentivizing the adoption of viable safer alternative chemicals or processes. California and Maine are beginning to implement such programs, requiring manufacturers of consumer products containing certain chemicals of concern to identify and evaluate potential safer alternatives. In the European Union, the REACH program imposes similar obligations on manufacturers of certain substances of very high concern. Effective prevention‐based regulation requires regulatory alternatives analysis (RAA), a methodology for comparing and evaluating the regulated chemical or process and its alternatives across a range of relevant criteria. RAA has both public and private dimensions. To a significant degree, alternatives analysis is an aspect of product design; that is, the process by which private industry designs the goods it sells. Accordingly, an RAA method should reflect the attributes of well‐crafted product design tools used by businesses. But RAA adds health and environmental objectives to the mix of concerns taken into account by the product designer. Moreover, as part of a prevention‐based regulatory regime, it implicates important public values such as legitimacy, equity, public engagement, and accountability. Thus, an RAA should reflect both private standards and public values, and be evaluated against them. This article adopts that perspective, identifying an integrated set of design principles for RAA, and illustrating the application of those principles.     

Causes of accidents and the time of day

Abstract

The relationship between accidents and the time of day is not entirely clear. Although there is considerable evidence that performance is poorest in the early morning hours compared to at all other times, the degree to which this is translated into accidents is not understood. In this study work-related fatal accidents were analysed to determine whether the causes of these accidents vary with time. The analysis used a classification and coding system devised to describe the wider circumstances of the causes of fatalities. In terms of absolute numbers, fatalities were most common in the late morning or early afternoon. When these results were expressed in terms of the estimated number of workers at work, the proportion of fatal accidents occurring at night was more than double that occurring during the day. Behavioural factors were the most common cause of fatalities at all times, but most common in the early hours of the morning. Further analysis of the nature of the behavioural involvement showed that errors in automatic processing (skill-based errors) were the most common types of error and did not vary much with time of day. Rule-based errors were most common during the day whereas knowledge-based errors occurred mainly in the afternoon and night shifts. These results cast some doubt on the assumption that there is a direct relationship between the previously observed variations in performance across time and the ultimate safety outcome.     

An examination of the strategic and operational impact of global sourcing on UK small firms

This paper presents three in-depth case studies of UK small manufacturers from the electronics manufacturing industry with global supply chains. There is no overlap in products, suppliers or customers and over time, each has developed a distinct and different strategy for managing an extended supply chain. The outcomes and experiences though are not markedly different. The operational challenges they encounter around quality and delivery, as well as the strategic dimensions of information asymmetry and capability fit are discussed. The study identifies the financial risks the firms are exposed to, the constraints to innovation and the wider strategic implications for long-term business performance.     

The effects of child support guidelines: An analysis of the evidence in court records

Court records from four Ohio counties were used to compare child support orders before and after promulgation of federally mandated guidelines in 1987. There was no significant change in probability of Court Ordered Child Support. Amount Ordered in constant dollars increased between 1985 and 1987–88. Variables influencing Court Ordered Child Support differed post-guidelines. Years Married, Attorney for Both and Attorney for Wife were significant in both years. Number of Children, Rural, and Wife's Motions were significant in 1987–88. Variables affecting amount ordered also differed after adoption of the guidelines. Wife Contested, Husband's Motions, Defendant and Plaintiff no longer were significant in 1987–88. Years Married and Payment by Father were significantly related to Amount Ordered in 1985 but not in 1987–88. Number of Children, Expenses Paid, and Number of Assets were significantly related to Amount Ordered in both years.Salaries and research support were provided by state and federal appropriations to the Ohio Agricultural Research and Development Center, and by the Department of Family Resource Management, and The Office of Research and Graduate Studies, The Ohio State University.Kathryn Stafford is Associate Professor, Department of Family Resource Management, 1787 Neil Avenue, Columbus, OH 43210-1295. Her research interests include household management and time use. She received her Ph.D. from Cornell University.Golden Jackson is Assistant Professor, Department of Family Resource Management, 1787 Neil Avenue, Columbus, OH 43210-1295. Her research is primarily in the area of the economic effects of divorce. She received her Ph.D. from The Ohio State University.Sharon Seiling is Assistant Professor and Extension Specialist in Family Resource Management, Department of Family Resource Management, 1787 Neil Avenue, Columbus, OH 43210-1295. Her research is on the impact of family change, especially divorce, on access to housing and overall financial well-being. She received her Ph.D. from Cornell University.     

Bisexuals Making Out with Cyborgs: Politics, Pleasure, Con/fusion

This article considers the appeal of the figure of the cyborg for bisexuals, offering bisexual readings of both Donna Haraway's cyborg, and of the cyborg self created within text-based virtual reality. The writer argues that understanding bisexuality as part of a web of meanings and material realities can lead to a new political awareness, and suggests ways to make some of these connections. Through her analysis, she emphasises the role of technology in creating and developing contemporary bisexuality.     

Ethical challenges in conducting research with hard to reach families

This paper reflects on some of the ethical challenges encountered by the authors whilst undertaking sensitive qualitative research with parents and children who are traditionally hard to reach. The research aimed to provide more holistic and in‐depth accounts of parenting on a low income in diverse social circumstances than already exist. The nature of the sample and the subject matter that was covered inevitably raised many familiar ethical dilemmas and some that are less often encountered in practice, particularly in relation to child protection. In this article we discuss our approach to ethics, some of the ethical challenges we encountered undertaking work with families and discuss the complexity of decision‐making around risk of harm to children. We conclude that a clear framework to avoid harm should be developed at the outset and a transparent approach to child protection issues should be used. Additional time and resources need to be incorporated at the planning stage of similar projects in order to develop appropriate methods, ensure effective decision‐making and support researchers. Copyright © 2008 John Wiley & Sons, Ltd.